Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-848d4c4894-xfwgj Total loading time: 0 Render date: 2024-07-05T15:29:02.646Z Has data issue: false hasContentIssue false

5 - The management of depression in patients with coronary heart disease

from Part 2 - Depression and specific health problems

Published online by Cambridge University Press:  17 September 2009

By
Robert M. Carney  and
Kenneth E. Freedland
Edited by
Andrew Steptoe
Robert M. Carney
Affiliation:
Behavioral Medicine Center Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
Kenneth E. Freedland
Affiliation:
Behavioral Medicine Center, Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
Andrew Steptoe
Affiliation:
University College London
Get access

Summary

Introduction

Patients who survive an acute myocardial infarction (MI) often face a difficult period of psychological and social adjustment. During the weeks and months following an MI, survivors are confronted with the possibility of being physically incapacitated, of having another heart attack and of dying. Their usual roles and daily routines may be disrupted, their self-esteem may be injured, and some of their hopes and plans may be jeopardised. Even patients with stable coronary heart disease (CHD) who have never had an MI or other major cardiac event must live with the possibility that they might eventually have a heart attack, and many of them have to cope with angina pectoris, fatigue and other debilitating symptoms.

Given the stressors with which patients with CHD are confronted, it is not surprising that depression and anxiety are very common in these individuals. As many as 65% of post-MI patients are at least mildly anxious or depressed [1–3]. Although some patients return to their premorbid mood state within a few days or weeks after their MI, many have, or will develop, a more serious or persistent form of clinical depression.

Depressive disorders

The Diagnostic and Statistical Manual of Mental Disorders, 4th edn (DSM-IV-TR) of the American Psychiatric Association [4] defines the most widely used criteria for diagnosing psychiatric disorders. As described in DSM-IV-TR, major depression is a serious psychiatric disorder that tends to follow a chronic or recurrent course.

Keywords

antidepressant medicationscognitive-behavioural therapycoronary heart diseasedepressioninterpersonal psychotherapyselective serotonin reuptake inhibitors
Type
Chapter
Information
Depression and Physical Illness , pp. 109 - 124
Publisher: Cambridge University Press
Print publication year: 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Cay, E. L., Vetter, N., Philip, A. E., Dugard, P., Psychological status during recovery from an acute heart attack. J. Psychosom. Res. 16 (1972), 425–35.Google Scholar
Croog, S. H., Levine, S., Life After Heart Attack (New York: Human Sciences Press, 1982).
Cassem, H., Hackett, T. P., Psychiatric consultation in a coronary care unit. Ann. Intern. Med. 75 (1971), 9–14.Google Scholar
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th edn, text revision (Washington, DC: American Psychiatric Association, 2000).
Schleifer, S. J., Macari-Hinson, M. M., Coyle, D. A., et al., The nature and course of depression following myocardial infarction. Arch. Intern. Med. 149 (1989), 1785–9.Google Scholar
Carney, R. M., Freedland, K. E., Jaffe, A. S., Insomnia and depression prior to myocardial infarction. Psychosom. Med. 52 (1990), 603–9.Google Scholar
Frasure-Smith, N., Lespérance, F., Talajic, M., Depression following myocardial infarction: impact on 6 month survival. J. Am. Med. Assoc. 270 (1993), 1819–25.Google Scholar
Lespérance, F., Frasure-Smith, N., Taljic, M, Major depression before and after myocardial infarction: its nature and consequences. Psychosom. Med. 58 (1996), 99–110.Google Scholar
Carney, R. M., Rich, M. W., Tevelde, A. J., et al., Major depressive disorder in coronary artery disease. Am. J. Cardiol. 60 (1987), 1273–5.Google Scholar
Gonzalez, M. B., Snyderman, T. B., Colket, J. T., et al., Depression in patients with coronary artery disease. Depression 4 (1997), 57–62.Google Scholar
Hance, M., Carney, R. M., Freedland, K. E., Skala, J., Depression in patients with coronary heart disease: a twelve month follow-up. Gen. Hosp. Psychiatry 18 (1995), 61–5.Google Scholar
Stern, M. J., Pascale, L., McLoone, J. B., Psychosocial adaption following an acute myocardial infarction. J. Chronic. Dis. 29 (1976), 213–26.Google Scholar
Mayou, R., Foster, A., Williamson, B., Psychosocial adjustment in patients one year after myocardial infarction. J. Psychosom. Res. 22 (1978), 447–53.Google Scholar
Lloyd, G. G., Cawley, R. H., Distress or illness? A study of psychosocial symptoms after myocardial infarction. Br. J. Psychiatry 142 (1983), 120–25.Google Scholar
Stewart, A. L., Greenfield, S., Hays, R. D., et al., Functional status and well-being of patients with chronic conditions: results from the Medical Outcomes Study. J. Am. Med. Assoc. 262 (1989), 907–13.Google Scholar
Wells, K. B., Stewart, A., Hays, R., et al., The functioning and well-being of depressed patients: results from the Medical Outcomes Study. J. Am. Med. Assoc. 262 (1989), 914–19.Google Scholar
Carney, R. M., Rich, M. W., Freedland, K. E., et al., Major depressive disorder predicts cardiac events in patients with coronary artery disease. Psychosom. Med. 50 (1988), 627–33.Google Scholar
Barefoot, J. C., Helms, M. J., Mark, D. B., et al., Depression and long-term mortality risk in patients with coronary artery disease. Am. J. Cardiol. 78 (1996), 613–17.Google Scholar
Connerney, I., Shapiro, P., McLaughlin, J. S., Sloan, R. P., In hospital depression after CABG surgery predicts 12-month outcome. Psychosom. Med. 62 (2000), 106.Google Scholar
Burg, M. M., Benedetto, C. M., Rosenberg, R., Soufer, R., Depression prior to CABG predicts 6-month and 2-year morbidity and mortality. Psychosom. Med. 63 (2001), 103.Google Scholar
Blumenthal, J. A., Lett, H. S., Babyak, M. A., et al., Depression as a risk factor for mortality after coronary artery bypass surgery. Lancet 362 (2003), 604–9.Google Scholar
Irvine, J., Basinski, A., Baker, B., et al., Depression and risk of sudden cardiac death after acute myocardial infarction: testing for the confounding effects of fatigue. Psychosom. Med. 61 (1999), 729–37.Google Scholar
Ahern, D. K., Gorkin, L., Anderson, J. L., et al., Biobehavioral variables and mortality or cardiac arrest in the Cardiac Arrhythmia Pilot Study (CAPS). Am. J. Cardiol. 66 (1990), 59–62.Google Scholar
Ladwig, K. H., Kieser, M., Konig, J., Breithardt, G., Borggrefe, M., Affective disorders and survival after acute myocardial infarction. Eur. Heart. J. 12 (1991), 959–64.Google Scholar
Carney, R. M., Blumenthal, J. A., Catellier, D., et al., Depression as a risk factor for mortality following acute myocardial infarction. Am. J. Cardiol. 92 (2003), 1277–81.Google Scholar
Bush, D. E., Ziegelstein, R. C., Tayback, M., et al., Even minimal symptoms of depression increase mortality risk after acute myocardial infarction. Am. J. Cardiol. 88 (2001), 337–41.Google Scholar
Kaufmann, M. W., Fitzgibbons, J. P., Sussman, E. J., et al., Relation between myocardial infarction, depression, hostility, and death. Am. Heart. J. 138 (1999), 549–54.Google Scholar
Pary, R. P., Tobias, C. R., Lippmann, S., Antidepressants and the cardiac patient: selecting an appropriate medication. Postgrad. Med. 85 (1989), 267–9.Google Scholar
Glassman, A. H., Roose, S. P., Bigger, J. T., The safety of tricyclic antidepressants in cardiac patients: risk/benefit reconsidered. J. Am. Med. Assoc. 269 (1993), 2673–5.Google Scholar
Warrington, S. J., Padgham, C., Lader, M., The cardiovascular effects of antidepressants. Psychol. Med. Monogr. Suppl. 16 (1989), 1–40.Google Scholar
Sheline, Y., Freedland, K. E., Carney, R. M., How safe are serotonin reuptake inhibitors for depression in patients with coronary heart disease?Am. J. Med. 102 (1997), 54–9.Google Scholar
Shores, M. M., Pascualy, M., Veith, R. C., Major depression and heart disease: treatment trials. Semin. Clin. Neuropsychiatry 3 (1998), 87–101.Google Scholar
Glassman, A. H., O'Connor, C. M., Califf, R. M., et al., Sertraline treatment of major depression in patients with acute MI or unstable angina. J. Am. Med. Assoc. 288 (2002), 701–9.Google Scholar
Keller, M. B., McCullough, J. P., Klein, D. N., et al., A comparison of nefazodone, the cognitive behavioral-analysis system of psychotherapy, and their combination for the treatment of chronic depression. N. Engl. J. Med. 342 (2000), 1462–9.Google Scholar
Beck, A. T., Rush, A. J., Shaw, B. F., Emery, G., Cognitive Therapy of Depression (New York: Guilford Press, 1979).
Klerman, G. L., Weissman, M. M., Rounsaville, B. J., Chevron, E. S., Interpersonal Psychotherapy of Depression (New York: Basic Books, 1984).
Elkin, I., Shea, M. T., Watkins, J. T., et al., National Institute of Mental Health Treatment of Depression Collaborative Research Program: general effectiveness of treatments. Arch. Gen. Psychiatry 46 (1989), 971–82.Google Scholar
Murphy, G. E., Simons, A. D., Wetzel, R. D., Lustman, P. J., Cognitive therapy and pharmacotherapy, singly and together in the treatment of depression. Arch. Gen. Psychiatry 41 (1984), 33–41.Google Scholar
Murphy, G. E., Carney, R. M., Wetzel, R. D., Knesevitch, M., Whitworth, P., Cognitive therapy and depression: a controlled treatment outcome study. Psychol. Rep. 77 (1995), 403–20.Google Scholar
Markowitz, J. C., G, Klerman, L., Perry, S. W., Clougherty, K. F., Mayers, A., Interpersonal therapy of depressed HIV-seropositive patients. Hosp. Community Psychiatry 43 (1992), 885–90.Google Scholar
H. C. Schulberg, C. P. Scott, M. J. Madonia, S. D. Imber, Applications of interpersonal psychotherapy to depression in primary care practice. In New Applications of Interpersonal Psychotherapy, ed. Klerman, G. L., Weisman, M. M. (Washington, DC: American Psychiatric Press, 1993), pp. 265–91.
Mossey, J. M., Knott, K. A., Higgins, M., Talerico, K., Effectiveness of a psychosocial intervention, interpersonal counseling, for subdysthymic depression in medically ill elderly. J. Gerontol. 51A (1996), M172–8.Google Scholar
Blumenthal, J. A., Emery, C. F., Rehabilitation of patients following myocardial infarction. J. Consult. Clin. Psychol. 56 (1988), 374–81.Google Scholar
Dixhoorn, J., Duivenvoorden, H. J., Pool, J., Verhage, F., Psychic effects of physical training and relaxation therapy after myocardial infarction. J. Psychsom. Res. 34 (1990), 327–37.Google Scholar
Oldenburg, B., Perkins, R. J., Andrews, G., Controlled trial of psychological intervention in myocardial infarction. J. Consult. Clin. Psychol. 53 (1985), 852–9.Google Scholar
Rahe, R. H., Ward, H. W., Hayes, V., Brief group therapy in myocardial infarction rehabilitation: three to four year follow-up of a controlled trial. Psychosom. Med. 41 (1979), 229–42.Google Scholar
Burgess, A. W., Lerner, D. J., D'Agostino, R. B., et al., A randomized controlled trial of cardiac rehabilitation. Soc. Sci. Med. 24 (1987), 359–70.Google Scholar
Oldridge, N. B., Guyat, G., Jones, N., et al., Effects on quality of life of comprehensive rehabilitation after acute myocardial infarction. Am. J. Cardiol. 67 (1991), 1084–9.Google Scholar
Lawlor, D. A., Hopker, S. W., The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials. Br. Med. J. 322 (2001), 1–8.Google Scholar
Blumenthal, J. A., Babyak, M. A., Moore, K. A., et al., Effects of exercise training on older patients with major depression. Arch. Intern. Med. 159 (1999), 2349–56.Google Scholar
Milani, R. V., Lavie, C. J., Prevalence and effects of cardiac rehabilitation on depression in the elderly with coronary heart disease. Am. J. Cardiol. 81 (1998), 1233–6.Google Scholar
Lavie, C. J., Milani, R. V., Cassidy, M. M., Gilliland, Y. E., Effects of cardiac rehabilitation and exercise training programs in women with depression. Am. J. Cardiol. 83 (1999), 1480–83.Google Scholar
Avery, D., Winokur, G., Mortality in depressed patients treated with electroconvulsive therapy and antidepressants. Arch. Gen. Psychiatry 33 (1976), 1029–37.Google Scholar
Sauer, W. H., Berlin, J. A., Kimmel, S. E., Effect of antidepressants and their relative affinity for the serotonin transporter on the risk of myocardial infarction. Circulation 108 (2003), 32–6.Google Scholar
Sauer, W. H., Berlin, J. A., Kimmel, S. E., Selective serotonin reuptake inhibitors and myocardial infarction. Circulation 104 (2001), 1894–8.Google Scholar
Hergovich, N., Aigner, M., Eichler, H. G., et al., Paroxetine decreases platelet serotonin storage and platelet function in human beings. Clin. Pharmacol. Ther. 68 (2000), 435–42.Google Scholar
Serebruany, V. L., O'Connor, C. M., Gurbel, P. A., Effect of selective serotonin reuptake inhibitors on platelets in patients with coronary artery disease. Am. J. Cardiol. 87 (2001), 1398–400.Google Scholar
Musselman, D. L., Marzec, U. M., Manatunga, A., et al., Platelet reactivity in depressed patients treated with paroxetine: preliminary findings. Arch. Gen. Psychiatry 57 (2000), 875–82.Google Scholar
Laghrissi-Thode, F., Wagner, W. R., Pollock, B. G., Johnson, P. C., Finkel, M. S., Elevated platelet factor 4 and β-thromboglobulin plasma levels in depressed patients with ischemic heart disease. Biol. Psychiatry 42 (1997), 290–95.Google Scholar
Carney, R. M., Freedland, K. E., Miller, G. E., Jaffe, A. S., Depression as a risk factor for cardiac mortality and morbidity: a review of potential mechanisms. J. Psychosom. Res. 53 (2002), 897–902.Google Scholar
Linden, W., Stossel, C., Maurice, J., Psychosocial interventions for patients with coronary artery disease: a meta-analysis. Arch. Intern. Med. 156 (1999), 745–52.Google Scholar
Powell, L. H., Unanswered questions in the Ischemic Heart Disease Life Stress Monitoring Program. Psychosom. Med. 51 (1989), 479–84.Google Scholar
Frasure-Smith, N., Lespérance, F., Prince, R., et al., Randomized trial of home based psychosocial nursing intervention for patients recovering from myocardial infarction. Lancet 350 (1997), 473–9.Google Scholar
Jones, D. A., West, R. R., Psychological rehabilitation after myocardial infarction: multicentre randomized controlled trial. Br. Med. J. 313 (1996), 1517–21.Google Scholar
Blumenthal, J. A., Jiang, W., Babyak, M. A., et al., Stress management and exercise training in cardiac patients with myocardial ischemia. Arch. Intern. Med. 157 (1997), 2213–23.Google Scholar
ENRICHD investigators. Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD): study design and methods. Am. Heart J. 139 (2000), 1–9.
ENRICHD investigators. Effects of treating depression and low perceived social support on clinical events after a myocardial infarction: the Enhancing recovery in Coronary Heart Disease Patients (ENRICHD) randomized trial. J. Am. Med. Assoc. 289 (2003), 3106–16.
Carney, R. M., Blumenthal, J. A., Freedland, K. E., et al., Depression and late mortality after myocardial infarction in the Enhancing Recovery in Coronary Heart Disease (ENRICHD) study. Psychosom. Med. 66 (2004), 466–74.Google Scholar
Freedland, K. E., Rich, M. W., Skala, J. A., et al., Depression in hospitalized patients with congestive heart failure. Psychosom. Med. 63 (2001), 177.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

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 Dropbox.

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.

Available formats
×