Depression and Cardiac Disease: Epidemiology, Mechanisms, and Diagnosis. (7th April 2013)

• Record Type: Journal Article
• Authors: Huffman, Jeff C.; Celano, Christopher M.; Beach, Scott R.; Motiwala, Shweta R.; Januzzi, James L.
• Other Names: Hashimoto Kenji Academic Editor.
• Is Part Of: Cardiovascular psychiatry and neurology. Volume 2013(2013)
• Publication Date: 2013-04-07
• Subjects: Cardiovascular system -- Diseases -- Periodicals; Cardiovascular system -- Diseases -- Psychological aspects -- Periodicals; Psychiatry -- Periodicals; Cardiology -- Periodicals; Neurology -- Periodicals; Nervous system -- Diseases -- Periodicals; Cardiology; Cardiovascular system -- Diseases; Cardiovascular system -- Diseases -- Psychological aspects; Nervous system -- Diseases; Neurology; Psychiatry; Cardiovascular Diseases -- complications; Nervous System Diseases -- complications; Mental Disorders -- complications; Cardiology; Neurology; Psychiatry; Cardiovascular Diseases -- complications -- Periodicals; Nervous System Diseases -- complications -- Periodicals; Mental Disorders -- complications -- Periodicals; Cardiology -- Periodicals; Neurology -- Periodicals; Psychiatry -- Periodicals; Periodicals; Electronic journals; 616.81
• DOI: 10.1155/2013/695925
• Languages: English
• ISSNs: 2090-0163

Abstract

Abstract : In patients with cardiovascular disease (CVD), depression is common, persistent, and associated with worse health-related quality of life, recurrent cardiac events, and mortality. Both physiological and behavioral factors—including endothelial dysfunction, platelet abnormalities, inflammation, autonomic nervous system dysfunction, and reduced engagement in health-promoting activities—may link depression with adverse cardiac outcomes. Because of the potential impact of depression on quality of life and cardiac outcomes, the American Heart Association has recommended routine depression screening of all cardiac patients with the 2- and 9-item Patient Health Questionnaires. However, despite the availability of these easy-to-use screening tools and effective treatments, depression is underrecognized and undertreated in patients with CVD. In this paper, we review the literature on epidemiology, phenomenology, comorbid conditions, and risk factors for depression in cardiac disease. We outline the associations between depression and cardiac outcomes, as well as the mechanisms that may mediate these links. Finally, we discuss the evidence for and against routine depression screening in patients with CVD and make specific recommendations for when and how to assess for depression in this high-risk population.