Patients With Depression Are Less Likely to Follow Recommendations to Reduce Cardiac Risk During Recovery From a Myocardial Infarction

Abstract

DEPRESSION is common among patients recovering from myocardial infarction (MI)^1-4 and is an indepedent risk factor for 6-month² and 18-month³ mortality. Major depression has been reported in 15% to 20% of patients hospitalized for acute MI,^1-4 while approximately 45% have been found to have either major or minor depression.¹ In a study² from the Montreal Heart Institute, patients meeting modified criteria for the syndrome of major depression based on the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition (DSM-III-R), between 5 and 15 days following an MI had an almost 6-fold higher mortality at 6 months than those who were not depressed. In a study³ by the same group, those patients with mild to moderate symptoms of depression assessed by the Beck Depression Inventory (BDI) had an almost 8-fold greater risk of dying by 18 months than those who were not depressed. The relation between depression and survival remained even after controlling for other established prognostic factors, including Killip class and prior MI.^2,3