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4 - Depression and prognosis in cardiac patients

from Part 2 - Depression and specific health problems

Published online by Cambridge University Press:  17 September 2009

By
Heather S. Lett ,
Andrew Sherwood ,
Lana Watkins  and
James A. Blumenthal
Edited by
Andrew Steptoe
Heather S. Lett
Affiliation:
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
Andrew Sherwood
Affiliation:
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
Lana Watkins
Affiliation:
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
James A. Blumenthal
Affiliation:
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
Andrew Steptoe
Affiliation:
University College London
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Summary

Coronary heart disease (CHD) is the leading cause of death in the USA and Europe [1, 2]. In roughly half the cases, the first clinical manifestations of CHD – myocardial infarction (MI) or sudden death – are catastrophic. These events are sudden, unexpected and unpredictable. The economic cost of CHD is growing. For example, in the USA over $130 billion is spent on CHD each year in direct medical costs, disability payments and lost productivity [2]. Moreover, traditional risk factors such as cigarette smoking, hyperlipidaemia and hypertension do not account fully for the timing and occurrence of these events.

Depression is also a major health problem. It is associated with significant impairment of function, which may, at times, be worse than that of chronic medical disorders [3]. Depressive symptoms have been correlated with the presence of one or more chronic diseases [4, 5], as well as inability to work [6], days in bed or days away from normal activities [4], increased mortality risk [7], increased use of medical services [8], and decreased wellbeing and lowered functioning [3]. Major depressive disorder (MDD) is the most prevalent of all psychiatric disorders, affecting up to 25% of women and 12% of men during their lifetime [9]. Since 1950, the prevalence of depression has increased significantly [10].

Depression is disproportionately prevalent among cardiac patients, with estimates of MDD of about 15% in patients following acute myocardial infarction (AMI) or coronary artery bypass graft (CABG), and an additional 20% with either minor depression or elevated levels of depressive symptoms as measured by questionnaires such as the Beck Depression Inventory (BDI) [11–17].

Keywords

acute myocardial infarctionbeck depression inventorybiobehavioural mechanismscardiac patientsdepressionmajor depressive disordercoronary artery bypass graftcoronary heart disease
Type
Chapter
Information
Depression and Physical Illness , pp. 87 - 108
Publisher: Cambridge University Press
Print publication year: 2006

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  • Depression and prognosis in cardiac patients
    • By Heather S. Lett, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA, Andrew Sherwood, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA, Lana Watkins, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA, James A. Blumenthal, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
  • Edited by Andrew Steptoe, University College London
  • Book: Depression and Physical Illness
  • Online publication: 17 September 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544293.005
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  • Depression and prognosis in cardiac patients
    • By Heather S. Lett, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA, Andrew Sherwood, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA, Lana Watkins, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA, James A. Blumenthal, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
  • Edited by Andrew Steptoe, University College London
  • Book: Depression and Physical Illness
  • Online publication: 17 September 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544293.005
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Depression and prognosis in cardiac patients
    • By Heather S. Lett, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA, Andrew Sherwood, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA, Lana Watkins, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA, James A. Blumenthal, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
  • Edited by Andrew Steptoe, University College London
  • Book: Depression and Physical Illness
  • Online publication: 17 September 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544293.005
Available formats
×