Et al

Abstract

Do physicians screen for depression and treat it in patients who suffer a heart attack? It seems unlikely although the evidence suggests they should. Following a myocardial infarction, depression is as good a predictor of mortality as smoking, obesity, or indeed heart failure and an abundance of observational studies have explored the relation between psychological morbidity and coronary heart disease. In this issue of EBMH two such studies have been abstracted (page 42 and page 43) and two more are listed below ( J Psychosom Res 2006;61:493–9 OpenUrl CrossRef PubMed Web of Science ) ( Aust N Z J Psychiatry 2006;40:1025–30 OpenUrl CrossRef PubMed Web of Science ) . The safety and effectiveness of selective serotonin reuptake inhibitors in depressed patients with comorbid heart disease has also been demonstrated in a series of clinical trials: SADHART,¹ ENRICHD,² and CREATE.³ Given this body of evidence, the obvious question is whether the treatment of depression in these patients will reduce the likelihood of a future cardiac event?