[Depression following a first heart infarct; similarities with and differences from 'ordinary' depression]

To determine frequency and clinical features of major depressive disorder according to DSM IV criteria in patients following a first myocardial infarction.

Questionnaire.

Departments of Cardiology and Psychiatry, University Hospital Maastricht, the Netherlands.

Depression was assessed using the Zung 'Self-rating depression scale' (Zung-SDS) and the 'Symptom checklist' (SCL)-90 in 228 patients who filled the questionnaires out themselves (response: 60-70%), 1, 3, 6 en 12 months after their first heart attack. When the score on one or both lists was above threshold, the patient was invited for a clinical interview with a psychiatrist.

One month post infarction 10% were diagnosed with a major depressive episode, a percentage which increased to 34% one year post infarction. The clinical features of the depression in these patients were the same as in a matched sample of depressed psychiatric inpatients without a cardiac history, except that hostility was significantly increased in the post-infarction patients. There was no mortality.

Depressive disorder is a frequent comorbid disease after a first myocardial infarction.