Current Psychiatry Reports

, Volume 14, Issue 1, pp 1–7 | Cite as

Is There a High-Risk Subtype of Depression in Patients with Coronary Heart Disease?

MEDICOPSYCHIATRIC DISORDERS (WJ KATON, SECTION EDITOR)

Abstract

Depression is a risk factor for cardiac morbidity and mortality in patients with coronary heart disease, especially in those with a recent history of acute coronary syndrome. To improve risk stratification and treatment planning, it would be useful to identify the characteristics or subtypes of depression that are associated with the highest risk of cardiac events. This paper reviews the evidence concerning several putative depression subtypes and symptom patterns that may be associated with a high risk of morbidity and mortality in cardiac patients, including single-episode major depressive disorder, depression that emerges after a cardiac event, somatic symptoms of depression, and treatment-resistant depression.

Keywords

Coronary disease Coronary heart disease Subtype High risk Depression Depressive disorder Major depressive disorder Treatment-resistant depression Myocardial infarction Mortality Myocardial ischemia 

Notes

Acknowledgments

This work was supported in part by grant no. 1R01HL08933601A2 from the National Heart, Lung, and Blood Institute, National Institutes of Health (Bethesda, MD), and support from the Lewis and Jean Sachs Charitable Lead Trust.

Disclosure

No potential conflicts of interest relevant to this article were reported.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. 1.
    Carney RM, Freedland KE. Depression in patients with coronary heart disease. Am J Med. 2008;121(11 Suppl 2):S20–7.PubMedCrossRefGoogle Scholar
  2. 2.
    Nicholson A, Kuper H, Hemingway H. Depression as an aetiologic and prognostic factor in coronary heart disease: a meta-analysis of 6362 events among 146 538 participants in 54 observational studies. Eur Heart J. 2006;27(23):2763–74.PubMedCrossRefGoogle Scholar
  3. 3.
    van Melle JP, de Jonge P, Spijkerman TA, et al. Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: a meta-analysis. Psychosom Med. 2004;66(6):814–22.PubMedCrossRefGoogle Scholar
  4. 4.
    Barth J, Schumacher M, Herrmann-Lingen C. Depression as a risk factor for mortality in patients with coronary heart disease: a meta-analysis. Psychosom Med. 2004;66(6):802–13.PubMedCrossRefGoogle Scholar
  5. 5.
    Frasure-Smith N, Lesperance F, Talajic M. Depression following myocardial infarction. Impact on 6-month survival. JAMA. 1993;270(15):1819–25.PubMedCrossRefGoogle Scholar
  6. 6.
    Lane D, Carroll D, Ring C, et al. Effects of depression and anxiety on mortality and quality-of-life 4 months after myocardial infarction. J Psychosom Res. 2000;49(4):229–38.PubMedCrossRefGoogle Scholar
  7. 7.
    Lespérance F, Frasure-Smith N, Talajic M. Major depression before and after myocardial infarction: its nature and consequences. Psychosom Med. 1996;58(2):99–110.PubMedGoogle Scholar
  8. 8.
    de Jonge P, van den Brink RH, Spijkerman TA, et al. Only incident depressive episodes after myocardial infarction are associated with new cardiovascular events. J Am Coll Cardiol. 2006;48(11):2204–8.PubMedCrossRefGoogle Scholar
  9. 9.
    Dickens C, McGowan L, Percival C, et al. New onset depression following myocardial infarction predicts cardiac mortality. Psychosom Med. 2008;70(4):450–5.PubMedCrossRefGoogle Scholar
  10. 10.
    Goodman J, Shimbo D, Haas DC, et al. Incident and recurrent major depressive disorder and coronary artery disease severity in acute coronary syndrome patients. J Psychiatr Res. 2007;42(8):670–5.PubMedCrossRefGoogle Scholar
  11. 11.
    Grace SL, Abbey SE, Kapral MK, et al. Effect of depression on five-year mortality after an acute coronary syndrome. Am J Cardiol. 2005;96(9):1179–85.PubMedCrossRefGoogle Scholar
  12. 12.
    Spijkerman T, de Jonge P, van den Brink RH, et al. Depression following myocardial infarction: first-ever versus ongoing and recurrent episodes. Gen Hosp Psychiatry. 2005;27(6):411–7.PubMedCrossRefGoogle Scholar
  13. 13.
    Berkman LF, Blumenthal J, Burg M, et al. Effects of treating depression and low perceived social support on clinical events after myocardial infarction: the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) randomized trial. JAMA. 2003;289(23):3106–16.PubMedCrossRefGoogle Scholar
  14. 14.
    • Carney RM, Freedland KE, Steinmeyer B et al. History of depression and survival after acute myocardial infarction. Psychosom Med. 2009;71(3):253–259. This study included the largest sample evaluating the prognostic value of first versus recurrent episode of depression and mortality. It also provides an extensive comparison of medical and demographic factors between the groups. PubMedCrossRefGoogle Scholar
  15. 15.
    Parker GB, Hilton TM, Walsh WF, et al. Timing is everything: the onset of depression and acute coronary syndrome outcome. Biol Psychiatry. 2008;64(8):660–6.PubMedCrossRefGoogle Scholar
  16. 16.
    Glassman AH, Bigger Jr JT, Gaffney M. Psychiatric characteristics associated with long-term mortality among 361 patients having an acute coronary syndrome and major depression: seven-year follow-up of SADHART participants. Arch Gen Psychiatry. 2009;66(9):1022–9.PubMedCrossRefGoogle Scholar
  17. 17.
    Patten SB. Accumulation of major depressive episodes over time in a prospective study indicates that retrospectively assessed lifetime prevalence estimates are too low. BMC Psychiatry. 2009;9:19.PubMedCrossRefGoogle Scholar
  18. 18.
    Rice JP, Rochberg N, Endicott J, et al. Stability of psychiatric diagnoses. An application to the affective disorders. Arch Gen Psychiatry. 1992;49(10):824–30.PubMedCrossRefGoogle Scholar
  19. 19.
    • Zuidersma M, Thombs BD, de JP. Onset and recurrence of depression as predictors of cardiovascular prognosis in depressed acute coronary syndrome patients: a systematic review. Psychother Psychosom. 2011;80(4):227–237. This article provides a thorough, thoughtful review of the literature examining first-time versus recurrent depression, and timing of depression onset in relation to cardiac outcomes. PubMedCrossRefGoogle Scholar
  20. 20.
    Bush DE, Ziegelstein RC, Tayback M, et al. Even minimal symptoms of depression increase mortality risk after acute myocardial infarction. Am J Cardiol. 2001;88(4):337–41.PubMedCrossRefGoogle Scholar
  21. 21.
    Lesperance F, Frasure-Smith N, Talajic M, et al. Five-year risk of cardiac mortality in relation to initial severity and one-year changes in depression symptoms after myocardial infarction. Circulation. 2002;105(9):1049–53.PubMedCrossRefGoogle Scholar
  22. 22.
    American Psychiatric Association, American Psychiatric Association, Task Force on DSM-IV. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). 4th ed., text revision ed. Washington, DC: American Psychiatric Association; 2000.Google Scholar
  23. 23.
    Fraguas Jr R, Iosifescu DV, Alpert J, et al. Major depressive disorder and comorbid cardiac disease: is there a depressive subtype with greater cardiovascular morbidity? Results from the STAR*D study. Psychosomatics. 2007;48(5):418–25.PubMedCrossRefGoogle Scholar
  24. 24.
    Martens EJ, Denollet J, Pedersen SS, et al. Relative lack of depressive cognitions in post-myocardial infarction depression. J Affect Disord. 2006;94(1–3):231–7.PubMedCrossRefGoogle Scholar
  25. 25.
    de Jonge P, Ormel J, van den Brink RH, et al. Symptom dimensions of depression following myocardial infarction and their relationship with somatic health status and cardiovascular prognosis. Am J Psychiatry. 2006;163(1):138–44.PubMedCrossRefGoogle Scholar
  26. 26.
    Doyle F, Conroy R, McGee H, et al. Depressive symptoms in persons with acute coronary syndrome: specific symptom scales and prognosis. J Psychosom Res. 2010;68(2):121–30.PubMedCrossRefGoogle Scholar
  27. 27.
    Hoen PW, Whooley MA, Martens EJ, et al. Differential associations between specific depressive symptoms and cardiovascular prognosis in patients with stable coronary heart disease. J Am Coll Cardiol. 2010;56(11):838–44.PubMedCrossRefGoogle Scholar
  28. 28.
    Linke SE, Rutledge T, Johnson BD, et al. Depressive symptom dimensions and cardiovascular prognosis among women with suspected myocardial ischemia: a report from the National Heart, Lung, and Blood Institute-sponsored Women's Ischemia Syndrome Evaluation. Arch Gen Psychiatry. 2009;66(5):499–507.PubMedCrossRefGoogle Scholar
  29. 29.
    Martens EJ, Hoen PW, Mittelhaeuser M, et al. Symptom dimensions of post-myocardial infarction depression, disease severity and cardiac prognosis. Psychol Med. 2010;40(5):807–14.PubMedCrossRefGoogle Scholar
  30. 30.
    Roest AM, Thombs BD, Grace SL, et al. Somatic/affective symptoms, but not cognitive/affective symptoms, of depression after acute coronary syndrome are associated with 12-month all-cause mortality. J Affect Disord. 2011;131(1–3):158–63.PubMedCrossRefGoogle Scholar
  31. 31.
    Schiffer AA, Pelle AJ, Smith OR, et al. Somatic versus cognitive symptoms of depression as predictors of all-cause mortality and health status in chronic heart failure. J Clin Psychiatry. 2009;70(12):1667–73.PubMedCrossRefGoogle Scholar
  32. 32.
    Smolderen KG, Spertus JA, Reid KJ, et al. The association of cognitive and somatic depressive symptoms with depression recognition and outcomes after myocardial infarction. Circ Cardiovasc Qual Outcomes. 2009;2(4):328–37.PubMedCrossRefGoogle Scholar
  33. 33.
    Stewart JC, Janicki DL, Muldoon MF, et al. Negative emotions and 3-year progression of subclinical atherosclerosis. Arch Gen Psychiatry. 2007;64(2):225–33.PubMedCrossRefGoogle Scholar
  34. 34.
    Barefoot JC, Brummett BH, Helms MJ, et al. Depressive symptoms and survival of patients with coronary artery disease. Psychosom Med. 2000;62(6):790–5.PubMedGoogle Scholar
  35. 35.
    Frasure-Smith N, Lesperance F. Depression and other psychological risks following myocardial infarction. Arch Gen Psychiatry. 2003;60(6):627–36.PubMedCrossRefGoogle Scholar
  36. 36.
    Hoen PW, Conradi HJ, Denollet J, et al. Interview-based ratings of somatic and cognitive symptoms of depression and their impact on cardiovascular prognosis. Psychother Psychosom. 2010;79(5):319–20.PubMedCrossRefGoogle Scholar
  37. 37.
    Connerney I, Sloan RP, Shapiro PA, et al. Depression is associated with increased mortality 10 years after coronary artery bypass surgery. Psychosom Med. 2010;72(9):874–81.PubMedCrossRefGoogle Scholar
  38. 38.
    Pedersen SS, Denollet J, Daemen J, et al. Fatigue, depressive symptoms, and hopelessness as predictors of adverse clinical events following percutaneous coronary intervention with paclitaxel-eluting stents. J Psychosom Res. 2007;62(4):455–61.PubMedCrossRefGoogle Scholar
  39. 39.
    Tully PJ, Winefield HR, Baker RA, et al. Confirmatory factor analysis of the Beck Depression Inventory-II and the association with cardiac morbidity and mortality after coronary revascularization. J Health Psychol. 2011;16(4):584–95.PubMedCrossRefGoogle Scholar
  40. 40.
    Carney RM, Freedland KE. Are somatic symptoms of depression better predictors of cardiac events than cognitive symptoms in coronary heart disease? Psychosom Med. 2011; in press.Google Scholar
  41. 41.
    Brown TA. Confirmatory factor analysis for applied research. New York: Guilford Press; 2006.Google Scholar
  42. 42.
    Thombs BD, Grace SL, Ziegelstein RC. Do symptom dimensions of depression following myocardial infarction relate differently to physical health indicators and cardiac prognosis? Am J Psychiatry. 2006;163(7):1295–6.PubMedCrossRefGoogle Scholar
  43. 43.
    Thombs BD, Ziegelstein RC, Stewart DE, et al. Usefulness of persistent symptoms of depression to predict physical health status 12 months after an acute coronary syndrome. Am J Cardiol. 2008;101(1):15–9.PubMedCrossRefGoogle Scholar
  44. 44.
    Parashar S, Rumsfeld JS, Spertus JA, et al. Time course of depression and outcome of myocardial infarction. Arch Intern Med. 2006;166(18):2035–43.PubMedCrossRefGoogle Scholar
  45. 45.
    Carney RM, Blumenthal JA, Freedland KE, et al. Depression and late mortality after myocardial infarction in the Enhancing Recovery in Coronary Heart Disease (ENRICHD) study. Psychosom Med. 2004;66(4):466–74.PubMedCrossRefGoogle Scholar
  46. 46.
    van Melle JP. de JP, Honig A et al. Effects of antidepressant treatment following myocardial infarction. Br J Psychiatry. 2007;190:460–6.PubMedCrossRefGoogle Scholar
  47. 47.
    de Jonge P, Honig A, van Melle JP, et al. Nonresponse to treatment for depression following myocardial infarction: association with subsequent cardiac events. Am J Psychiatry. 2007;164(9):1371–8.PubMedCrossRefGoogle Scholar
  48. 48.
    Glassman AH, O'Connor CM, Califf RM, et al. Sertraline treatment of major depression in patients with acute MI or unstable angina. JAMA. 2002;288(6):701–9.PubMedCrossRefGoogle Scholar
  49. 49.
    Glassman AH, Bigger JT, Gaffney M. Psychiatric characteristics associated with long-term mortality among 361 patients having an acute coronary syndrome and major depression. Arch Gen Psychiatry. 2009;66(9):1022–1029.PubMedCrossRefGoogle Scholar
  50. 50.
    Milani RV, Lavie CJ. Impact of cardiac rehabilitation on depression and its associated mortality. Am J Med. 2007;120(9):799–806.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Behavioral Medicine Center, Department of PsychiatryWashington University School of MedicineSt. LouisUSA

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