(Circulation. 1996;93:1976-1980.)
© 1996 American Heart Association, Inc.
Articles |
Symptoms of Depression, Acute Myocardial Infarction, and Total Mortality in a Community Sample
From the Behavioral Medicine Research Center, Duke University Medical Center, Durham, NC; the Institute of Preventive Medicine, Copenhagen (Denmark) Municipal Hospital (J.B.); and Glostrup Population Studies, Copenhagen County Hospital (M.S.), Glostrup, Denmark.
Background Depression has been shown to adversely affect the prognosis of patients with established coronary artery disease, but there is comparatively little evidence to document the role of depression in the initial development of coronary disease.
Methods and Results Study participants were 409 men and 321 women who were residents of Glostrup, Denmark, born in 1914. Physical and psychological examinations in 1964 and 1974 established their baseline risk factor and disease status and their level of depressive symptomatology. Initial myocardial infarction (MI) was observed in 122 participants, and there were 290 deaths during follow-up, which ended in 1991. A 2-SD difference in depression score was associated with relative risks of 1.71 (P=.005) for MI and 1.59 (P<.001) for deaths from all causes. These findings were unchanged after we controlled for risk factors and signs of disease at baseline. There were no sex differences in effect sizes.
Conclusions High levels of depressive symptomatology are associated with increased risks of MI and mortality. The graded relationships between depression scores and risk, long-lasting nature of the effect, and stability of the depression measured across time suggest that this risk factor is best viewed as a continuous variable that represents a chronic psychological characteristic rather than a discrete and episodic psychiatric condition.
Key Words: depression • epidemiology • mortality • myocardial infarction • risk factors
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S. L. Stern, R. Dhanda, and H. P. Hazuda Hopelessness Predicts Mortality in Older Mexican and European Americans Psychosom Med, May 1, 2001; 63(3): 344 - 351. [Abstract] [Full Text] [PDF]
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B. W. J. H. Penninx, A. T. F. Beekman, A. Honig, D. J. H. Deeg, R. A. Schoevers, J. T. M. van Eijk, and W. van Tilburg Depression and Cardiac Mortality: Results From a Community-Based Longitudinal Study Arch Gen Psychiatry, March 1, 2001; 58(3): 221 - 227. [Abstract] [Full Text] [PDF]
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H. W. Cohen, S. Madhavan, and M. H. Alderman History of Treatment for Depression: Risk Factor for Myocardial Infarction in Hypertensive Patients Psychosom Med, March 1, 2001; 63(2): 203 - 209. [Abstract] [Full Text] [PDF]
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D. Lane, D. Carroll, C. Ring, D. G. Beevers, and G. Y. H. Lip Mortality and Quality of Life 12 Months After Myocardial Infarction: Effects of Depression and Anxiety Psychosom Med, March 1, 2001; 63(2): 221 - 230. [Abstract] [Full Text] [PDF]
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R. B. Williams, D. A. Marchuk, K. M. Gadde, J. C. Barefoot, K. Grichnik, M. J. Helms, C. M. Kuhn, J. G. Lewis, S. M. Schanberg, M. Stafford-Smith, et al. Central Nervous System Serotonin Function and Cardiovascular Responses to Stress Psychosom Med, March 1, 2001; 63(2): 300 - 305. [Abstract] [Full Text] [PDF]
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 P. G. O'Malley, D. L. Jones, I. M. Feuerstein, and A. J. Taylor Lack of Correlation between Psychological Factors and Subclinical Coronary Artery Disease N. Engl. J. Med., November 2, 2000; 343(18): 1298 - 1304. [Abstract] [Full Text] [PDF]
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A. A. Ariyo, M. Haan, C. M. Tangen, J. C. Rutledge, M. Cushman, A. Dobs, and C. D. Furberg Depressive Symptoms and Risks of Coronary Heart Disease and Mortality in Elderly Americans Circulation, October 10, 2000; 102(15): 1773 - 1779. [Abstract] [Full Text] [PDF]
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D. L. Musselman, U. M. Marzec, A. Manatunga, S. Penna, A. Reemsnyder, B. T. Knight, A. Baron, S. R. Hanson, and C. B. Nemeroff Platelet Reactivity in Depressed Patients Treated With Paroxetine: Preliminary Findings Arch Gen Psychiatry, September 1, 2000; 57(9): 875 - 882. [Abstract] [Full Text] [PDF]
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A. Appels, F. W. Bar, J. Bar, C. Bruggeman, and M. de Baets Inflammation, Depressive Symptomatology, and Coronary Artery Disease Psychosom Med, September 1, 2000; 62(5): 601 - 605. [Abstract] [Full Text] [PDF]
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J. Denollet, J. Vaes, and D. L. Brutsaert Inadequate Response to Treatment in Coronary Heart Disease : Adverse Effects of Type D Personality and Younger Age on 5-Year Prognosis and Quality of Life Circulation, August 8, 2000; 102(6): 630 - 635. [Abstract] [Full Text] [PDF]
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J. L. Januzzi Jr, T. A. Stern, R. C. Pasternak, and R. W. DeSanctis The Influence of Anxiety and Depression on Outcomes of Patients With Coronary Artery Disease Arch Intern Med, July 10, 2000; 160(13): 1913 - 1921. [Full Text] [PDF]
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N. Frasure-Smith and F Lesperance Coronary artery disease, depression and social support only the beginning Eur. Heart J., July 1, 2000; 21(13): 1043 - 1045. [PDF]
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B. S. Jonas and M. E. Mussolino Symptoms of Depression as a Prospective Risk Factor for Stroke Psychosom Med, July 1, 2000; 62(4): 463 - 471. [Abstract] [Full Text] [PDF]
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C. Sarti, D. Rastenyte, Z. Cepaitis, and J. Tuomilehto International Trends in Mortality From Stroke, 1968 to 1994 Stroke, July 1, 2000; 31(7): 1588 - 1601. [Abstract] [Full Text] [PDF]
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L. R. Wulsin Does Depression Kill? Arch Intern Med, June 26, 2000; 160(12): 1731 - 1732. [Full Text] [PDF]
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R. Schulz, S. R. Beach, D. G. Ives, L. M. Martire, A. A. Ariyo, and W. J. Kop Association Between Depression and Mortality in Older Adults: The Cardiovascular Health Study Arch Intern Med, June 26, 2000; 160(12): 1761 - 1768. [Abstract] [Full Text] [PDF]
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 R. Zahourek Alternative, Complementary, or Integrative Approaches to Treating Depression Journal of the American Psychiatric Nurses Association, June 1, 2000; 6(3): 77 - 86. [Abstract] [PDF]
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A. K. Ferketich, J. A. Schwartzbaum, D. J. Frid, and M. L. Moeschberger Depression as an Antecedent to Heart Disease Among Women and Men in the NHANES I Study Arch Intern Med, May 8, 2000; 160(9): 1261 - 1268. [Abstract] [Full Text] [PDF]
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F. Lesperance, N. Frasure-Smith, M. Juneau, and P. Theroux Depression and 1-Year Prognosis in Unstable Angina Arch Intern Med, May 8, 2000; 160(9): 1354 - 1360. [Abstract] [Full Text] [PDF]
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J. Irvine, A. Basinski, B. Baker, S. Jandciu, M. Paquette, J. Cairns, S. Connolly, R. Roberts, M. Gent, and P. Dorian Depression and Risk of Sudden Cardiac Death After Acute Myocardial Infarction: Testing for the Confounding Effects of Fatigue Psychosom Med, November 1, 1999; 61(6): 729 - 737. [Abstract] [Full Text] [PDF]
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W. Coryell, C. Turvey, A. Leon, J. D. Maser, D. Solomon, J. Endicott, T. Mueller, and M. Keller Persistence of Depressive Symptoms and Cardiovascular Death Among Patients With Affective Disorder Psychosom Med, November 1, 1999; 61(6): 755 - 761. [Abstract] [Full Text] [PDF]
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T. Rutledge, W. Linden, and R. F. Davies Psychological Risk Factors May Moderate Pharmacological Treatment Effects Among Ischemic Heart Disease Patients Psychosom Med, November 1, 1999; 61(6): 834 - 841. [Abstract] [Full Text] [PDF]
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