Depression in Acute Coronary Syndrome Patients

  • Deepika Makkar Psychiatry, Department of Psychiatry, Maulana Azad Medical College and Associated L.N., G.N.E.C and G.B. Pant Hospitals, New Delhi. https://orcid.org/0000-0002-0645-0673
  • RC Jiloha Professor and Head of Department, Department of Psychiatry, Hamdard Institute of Medical Sciences & Research & Affiliated Hospitals, Jamia Hamdard University, Delhi.
Keywords: Acute Coronary Syndrome, Depression

Abstract

Aims and Objectives: To study the prevalence of depression in Acute Coronary Syndrome (ACS) patients.

Methods: Patients diagnosed with Acute coronary syndrome and attending cardiology OPD after 2-4 weeks of index episode were the subjects (n=75). Study period was from st January 2011 to 29th Feb 2012. Patients already on antidepressants were excluded from the study. WHO Well Being Index was used as a screening tool. Diagnosis of depressive disorder was made through clinical interview as per the criteria given in International Classification of disease 10th ed. (ICD-10). Beck’s Depression Inventory (BDI) was applied to rate the severity of depressive episode. Socio demographic profile and other clinical variables of two groups (ACS with or without depression) were compared. It was a single point cross sectional study. Prevalence rate of depression was obtained and chi square test was applied to compare variables associated with depression in ACS.

Result: Prevalence of depressive disorder was found to be 22.7% (n=17) in our sample. Socio demographic and clinical variables were comparable between the two groups except for the history of current substance use (p=.045) and history of past depressive episode (p=0.021), which were significantly associated with depression in post ACS patients.

Conclusion: It could be concluded from the study that unrecognized and untreated depression was frequent in ACS patients 2-4 weeks after the index episode. In our study substance intake+ and past history of a depressive episode were the risk factors associated with depression post ACS and subjects with history of these should be screened specifically for depression and adequately treated.

How to cite this article:
Makkar D, Jiloha RC. Depression in Acute Coronary Syndrome Patients. J Adv Res Psychol Psychother 2019; 2(3&4): 23-28.

DOI: https://doi.org/10.24321/2581.5822.201912

References

WHO depression fact sheet. Available from: http://www.who.int/mental_health/management/depression

/definition/en/.

Verwoerdet A, Dovenmuehle RH. Heart disease and depression. Geriatrics 1964; 856-864.

Aromaa A, Raitasalo R, Reunanen A, Impivaara O, Heliövaara M, Knekt P et al. Depression and

cardiovascular diseases. Acta Psychiatr Scand 1994; 377(suppl): 77-82. [PubMed/ Google Scholar].

De Jonge P, Spijkerman TA, Van den Brink RH, Ormel J. Depression after myocardial infarction is a risk factor

for declining health related quality of life and increased disability and cardiac complaints at 12 months. Heart

; 92(1): 8-10. Available from: https://heart.bmj.com/content/92/1/32.long [PubMed/ Google Scholar].

Cassem NH, Hackett TP. Psychiatric consultation in coronary care unit. Ann Intern Med 1971; 75(1):

-14. Available from: https://annals.org/aim/articleabstract/685626/psychiatric-consultation-coronarycare-

unit [PubMed/ Google Scholar].

Cay EL, Vetter N, Philip AE et al. Psychological status during recovery from an acute heart attack. J

Psychosom Res 1972; 16(6): 425-435. Available from: https://www.sciencedirect.com/science/article/abs/

pii/0022399972900682 [Google Scholar].

Agarwal M, Trivedi JK, Sinh PK, Dalal PK, Saran RK. Depression in patients of myocardial infarction-a crosssectional study in northern India. J Assoc Physicians India 2011; 59: 636-638. [PubMed/ Google Scholar].

Ladwig KH, Lehmacher W, Roth R, Breithardt G, Budde T, Borggrefe M. Factors which provide post infarction

depression: results from post infarction study (PILP). J Psychosom Res 1992; 36(8): 723-729. [PubMed/

Google Scholar].

Travella JL, Forresster AW, Schultz SK. Depression following myocardial infarction; one year longitudinal

study. Int J Psychiatry Med 1994; 24: 357-369. Available from: https://journals.sagepub.com/doi/abs/10.2190/

U8R0-A61Y-AKRP-T24V [Google Scholar].

Gonzalez MB, Snyderman TB, Colket JT, Arias RM, Jiang JW, O’Connor CM et al. Depression in patients with

coronary artery disease. Depression 1996; 4(2): 57-62. Available from: https://onlinelibrary.wiley.com/doi/

abs/10.1002/(SICI)1522-7162(1996)4:2%3C57::AIDDEPR3%3E3.0.CO;2-C [Google Scholar].

Brummett BH, Babyak MA, Barefoot JC, Bosworth HB, Clapp-Channing NE, Siegler IC et al. Social support

and hostility as predictors of depressive symptoms in cardiac patients one month after hospitalizations:

a prospective study. Psychosom Med 1998; 60(6): 707-713. Available from: https://journals.lww.com/

psychosomaticmedicine/Abstract/1998/11000/Social_Support_and_Hostility_as_Predictors_of.8.aspx

[PubMed/ Google Scholar].

Carney RM, Rich MW, Freedland KE, Saini J, TeVelde A, Simeone C et al. Major depressive disorder in

coronary artery disease. Am J Cardiol 1987; 60: 1273-1275. Available from: https://journals.lww.com/

psychosomaticmedicine/Citation/1988/11000/Major_depressive_disorder_predicts_cardiac_events.9.aspx

[PubMed/ Google Scholar].

Forrester AW, Lipsey JR, Teitlbaum ML, DePaulo JR, Andrzejewski PL. Depression following myocardial

infarction. Int J Psychiatry Med 1992; 22(1): 33-46.

Available from: https://journals.sagepub.com/doi/abs/10.2190/CJ9D-32C2-8CM7-FT3D [PubMed/ Google

Scholar].

Frasure-Smith N, Lesperance F, Talajic M. Depression following myocardial infarction: impact on 6-month

survival. JAMA 1993; 270(15): 1819-1825. Available from: https://jamanetwork.com/journals/jama/articleabstract/

[PubMed/ Google Scholar].

Lesperance F, Frasure-Smith N, Juneau M, Theroux P. Depression and 1-year prognosis in unstable

angina. Arch Intern Med 2000; 160(9): 1354-1360. Available from: https://jamanetwork.com/journals/

jamainternalmedicine/fullarticle/485313 [PubMed/ Google Scholar].

Glassman AH, O’Connor CM, Califf RM, Swedberg K, Schwartz P. Sertraline Treatment of Major Depression in

Patients With Acute MI or Unstable Angina. JAMA 2002; 288(6): 701-709. Available from: https://jamanetwork.

com/journals/jama/fullarticle/195184 [PubMed/ Google Scholar].

Berkman LF, Blumenthal J, Burg M, Carney RM, Catellier D, Cowan MJ et al. Effects of treating depression

and low perceived social support on clinical events after myocardial infarction: the Enhancing Recovery

in Coronary Heart Disease Patients (ENRICHD) randomized trial. JAMA 2003; 289: 3106-3116. Available from: https://jamanetwork.com/journals/jama/fullarticle/196763 [PubMed/ Google Scholar].

Khawaja IS, Westermeyer JJ, Gajwani P, Feinstein RE. Depression and coronary artery disease: the

association, mechanisms, and therapeutic implications. Psychiatry (Edgmont) 2009; 6(1): 38-51. [PubMed/

Google Scholar].

Kuppuswamy B. Socioe-conomic status scale (urban). Mansayan, January 2002.

World Health Organization. The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. Geneva: A.I.T.B.S. Publishers & Distributors; 1992.

Beck AT, Steer RA, Brown GK. Manual for the Beck Depression Inventory–II. San Antonio, TX: Psychological

Corporation; 1996.

John S. Prevalence and pattern of psychiatric morbidity and health related quality of life in patients with

ischemic heart disease in a tertiary care hospital. Indian J Psychiatry 2013; 55(4): 353-359. Available

from: http://www.indianjpsychiatry.org/article.asp?issn=0019-5545;year=2013;volume=55;issue=4;

spage=353;epage=359;aulast=John [Google Scholar].

Manoj MT, Joseph KA, Vijayaraghavan G. Association of depression, anxiety, and stress with myocardial

infarction: A case-control study Year. Journal of Clinical and Preventive Cardiology 2018; 7(3): 86-92. [Google

Scholar].

Shruthi DR, Kumar SS, Desai N. Psychiatric comorbidities in acute coronary syndromes: Six-month follow-up study Year. IJoP 2018; 60(1): 60-64. Available from: http://

www.indianjpsychiatry.org/article.asp?issn=0019-5545;year=2018;volume=60;issue=1;spage=60;epag

e=64;aulast=Shruthi [Google Scholar].

O’Rourke A, Hampson SE. Psychosocial outcomes after an MI: an evaluation of two approaches to

rehabilitation. Psychol Health & Med 1999; 4(4): 393-402. Available from: https://www.tandfonline.com/

doi/abs/10.1080/135485099106144 [Google Scholar].

Lauzon C, Beck CA, Huynh T. Depression and prognosis following hospital admission because of acute

myocardial infarction. CMAJ 2003; 168(5): 547-552. [PubMed/ Google Scholar].

Berkman LF, Blumenthal J, Burg M, Carney RM, Catellier D, Cowan MJ et al. Effects of treating depression and

low perceived social support on clinical events after myocardial infarction: the Enhancing Recovery in

Coronary Heart Disease Patients (ENRICHD) randomized trial. JAMA 2003; 289(23): 3106-3116. [PubMed/

Google Scholar].

Barefoot JC, Burg MM, Carney RM, et al. Aspects of social support associated with depression at

hospitalization and follow-up assessment among cardiac patients. J Cardiopulm Rehabil 2003; 23(6):

-412. Available from: https://insights.ovid.com/article/00008483-200311000-00002 [PubMed/ Google

Scholar].

Clarke DE, Walker JR, Cuddy TE. The role of perceived overprotectiveness in recovery 3 months after

myocardial infarction. J Cardiopulm Rehabil 1996; 16: 372-377. Available from: https://journals.lww.

com/jcrjournal/Abstract/1996/11000/The_Role_of_Perceived_Overprotectiveness_in.6.aspx.

Lehto S, Koukkunen H, Hintikka J, Viinamaki H, Laakso M, Pyorala K et al. Depression after coronary heart

disease events. Scand Cardiovasc J 2000; 34: 580-583. [Google Scholar].

Thombs BD, Bass EB, Ford DE. Prevalence of depression in survivors of acute myocardial infarction. J Gen Intern Med 2006; 21(1): 30-38. [PubMed/ Google Scholar].

Bjerkeset O, Nordahl HM, Mykletun A, Holmen J, Dahl AA. Anxiety and depression following myocardial

infarction: gender differences in a 5-year prospectivestudy. J Psychosom Res 2005; 58(2): 153-161. [PubMed/

Google Scholar].

Parker GB, Hilton TM, Walsh WF, et al. Timing is everything: the onset of depression and acute coronary

syndrome outcome. Biol Psychiatry 2008; 64: 660-666. [Google Scholar].

Busch AM, Borrelli B, Leventhal AM. The Relationship between Smoking and Depression Post-Acute Coronary

Syndrome. Curr Cardiovasc Risk Rep 2012; 5(6): 510-518. [PubMed/ Google Scholar].

Freedland KE, Carney RM, Skala JA. Depression and smoking in coronary heart disease. Psychosom Med

; 67(Suppl 1): S42-S46. Available from: https://bmcmedicine.biomedcentral.com/articles/10.1186

/1741-7015-11-131

Anda RF, Williamson DF, Escobedo LG et al. Depression and the dynamics of smoking. A national perspective.

JAMA 1990; 264: 1541-1545.

Breslau N, Peterson EL, Schultz LR, Chilcoat HD, Andreski P. Major depression and stages of smoking:

a longitudinal investigation. Arch Gen Psychiatry 1998; 55(2): 161-166. [PubMed/ Google Scholar].

Spijkerman TA, van den Brink RH. Who is at risk of post-MI depressive symptoms? J Psychosom Res 2005;

(5): 425-432. 433-434. [Google Scholar].

Martens EJ, Smith OR . Cardiac history, prior depression and personality predict course of depressive symptoms after myocardial infarction. Psychol Med 2008; 38(2): 257-264. [PubMed].

Strik JJ, Honig A, Lousberg Clinical correlates of depression following myocardial infarction. Int J

Psychiatry Med 2001; 31(3): 255-264. [PubMed/ Google Scholar].

Barth J. Depression as a Risk Factor for Mortality in Patients With Coronary Heart Disease: A Metaanalysis.

Psychosomatic Medicine 2004; 66(6): 802-813. [PubMed/ Google Scholar].

Davidson KW, Rieckmann N, Rapp MA. Definitions and Distinctions Among Depressive Syndromes and

Symptoms: Implications for a Better Understanding of the Depression-Cardiovascular Disease Association.

Psychosomatic Medicine 2005; 67(Suppl 1): S6-S9. [PubMed/ Google Scholar].

Goodman J. Incident and Recurrent Major Depressive Disorder and Coronary Artery Disease Severity in Acute

Coronary Syndrome Patients. J Psychiatr Res 2008; 42(8): 670-675. [PubMed/ Google Scholar].

Bush DE, Ziegelstein RC, Tayback M. Even minimal symptoms of depression increase mortality risk after

acute myocardial infarction. Am J Cardiol 2001; 88(4): 337-341. [PubMed/ Google Scholar].

JH, Bigger JT Jr, Blumenthal JA, Frasure-Smith N. AHA science advisory. Depression and coronary heart

disease. Recommendations for screening, referral, and treatment. Lichtman Prog Cardiovasc Nurs 2009;

(1): 19-26.

Published
2020-04-01
How to Cite
Makkar, D., & Jiloha, R. (2020). Depression in Acute Coronary Syndrome Patients. Journal of Advanced Research in Psychology & Psychotherapy (E-ISSN: 2581-5822), 2(3&4), 23-28. Retrieved from http://medical.advancedresearchpublications.com/index.php/Psychology-Psychotherapy/article/view/207