[The anti-depressive effects of post-infarct exercises]

Twenty-nine per cent of patients hospitalized following their first myocardial infarction (MI) are depressed. This percentage decreases with time to 15 per cent at six weeks, and fluctuates between 10 and 13 per cent at three and six months post-MI, respectively. This literature review indicates that exercise training programs are not the treatment of choice to reduce severe post-MI depression. However, in moderately depressed MI patients, their sense of humor is improved, especially if the exercise component involves some degree of socialization and counselling. The lack of significant findings may be compounded by other factors such as incorporating other life-style modifications, the patients' expectations and self-efficacy, and the type of measurement utilized to detect changes in depression levels over time. The type of depression scale used in most studies, the Minnesota Multiphasic Personality Inventory (MMPI), may also be incorrect for MI patients, since the etiology of post-MI depression varies from minor depression to a major depressive episode. The MMPI was developed for use with persons with psychiatric illness. Post-MI depression is considered a normal "uncomplicated bereavement" for the majority of patients. The optimal method used to identify post-MI depression following hospitalization seems to be observation and interview. This is essential to pinpoint the symptoms characteristic of uncomplicated bereavement.