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The relationship of depression to cardiovascular disease: epidemiology, biology, and treatment
D L Musselman1, D L Evans, C B Nemeroff
1Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA.
Insights
Depression is a significant risk factor for heart disease development and mortality. Treating depression in cardiovascular disease patients improves symptoms and quality of life.
Area of Science:
- Cardiology
- Psychiatry
- Psychosomatic Medicine
Background:
- Mood disorders, particularly major depression, are prevalent in cardiovascular disease (CVD) patients.
- Depression is often underdiagnosed and undertreated in individuals with heart conditions.
- Depression is a significant risk factor for CVD development and mortality post-myocardial infarction.
Purpose of the Study:
- To review the existing literature on the relationship between mood disorders and heart disease.
- To examine pathophysiological alterations in depressed patients with CVD.
- To describe current treatment approaches for depression in CVD patients.
Main Methods:
- Literature review of MEDLINE searches from 1966-1997.
- Search terms included: "major depression," "psychiatry," "cardiovascular disease," and "pathophysiology."
- Analysis of studies on pathophysiological changes and treatment outcomes.
Main Results:
- Depression is a major risk factor for developing CVD and mortality after myocardial infarction.
- Pathophysiological links between depression and CVD are explored.
- Limited studies indicate treatment of depression in CVD patients improves symptoms and quality of life.
Conclusions:
- There is a critical link between depression and cardiovascular disease.
- Effective treatment of depression in CVD patients can enhance well-being and potentially longevity.
- Further research is recommended to elucidate these connections and optimize treatment strategies.
Abstract:
This article reviews the burgeoning literature on the relationship of mood disorders and heart disease. Major depression and depressive symptoms, although commonly encountered in medical populations, are frequently underdiagnosed and undertreated in patients with cardiovascular disease (CVD). This is of particular importance because several studies have shown depression and its associated symptoms to be a major risk factor for both the development of CVD and death after an index myocardial infarction. This review of the extant literature is derived from MEDLINE searches (1966-1997) using the search terms "major depression," "psychiatry," "cardiovascular disease," and "pathophysiology." Studies investigating pathophysiological alterations related to CVD in depressed patients are reviewed. The few studies on treatment of depression in patients with CVD are also described. Treatment of depression in patients with CVD improves their dysphoria and other signs and symptoms of depression, improves quality of life, and perhaps even increases longevity. Recommendations for future research are proposed.