Heart Patients Mentally Vulnerable -- MEDICA - World Forum for Medicine

Heart Patients Mentally Vulnerable

"Depression and heart disease seem to be very much intertwined", said Judith H. Lichtman, co-chair of the statement. "You cannot treat the heart in isolation from the patient's mental health."

The American Psychiatric Association has endorsed the statement. Some of its recommendations include: routine and frequent screening for depression in patients with chronic heart disease in a variety of settings, including the hospital, physician's office and cardiac rehabilitation center; help for patients with positive screening results by a professional qualified to diagnose and manage treatment for depression; careful monitoring of patients to ensure adherence to their treatment plan; coordination between health care professionals treating patients with combined medical and mental health diagnoses.

While there is no evidence that screening for depression leads to improved outcomes for people with cardiovascular complications, the advisory does state that depression is linked with increased morbidity and mortality, lower rates of cardiac rehabilitation and poorer quality of life. "By understanding the prevalence of depression and learning more about the subgroups of heart patients at particular risk of depression, we can begin to understand the best ways to recognise and treat it," said Lichtman.

Depression is approximately three times more common in people with heart complications than in the general population and as many as 20 percent of heart patients meet the criteria for major depression. Studies suggest that younger women in particular may be at high risk.

The advisory recommends that heart patients initially be evaluated with a simple two-item assessment. If even one of the questions generates a "yes" response, it is recommended that a more in-depth screening be done with a total of nine questions. Heart patients found to be suffering from depression can benefit from a number of treatment options, including behavioural therapy, physical activity, cardiac rehabilitation, antidepressant drugs, or combinations of these treatments.

MEDICA.de; Source: Yale University