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Clinical Depression and Increased Risk of Death Following a Heart Attack

 

It has been known for some time that heart attack patients who also experience clinical depression are at a much higher risk for subsequent heart attacks in the months following the initial attack.  Now, researchers from Washington University in St. Louis, Missouri have found that the risk probably continues for many years after. 

Robert M. Carney, Ph.D., professor of psychiatry at Washington University and the lead author of the new study stated that "There's a two to fourfold increase in a person's risk of dying following a heart attack if they also happen to be depressed."  He went on to say that "Previously we thought the impact of depression was strongest for the first three to six months following a heart attack and then gradually dropped off within a couple of years.  Instead, we found that the effect lasts for at least five years." 

Dr. Carney, along with colleagues from Yale University, Duke University Medical Center, Harvard University and the National Heart, Lung and Blood Institute (NIH) and the Mayo Clinic, studied more than 750 heart attack patients for five years.  Patients in the study had participated in the NIH funded project Enhancing Recovery in Coronary Heart Disease with a little less than half being diagnosed as having depression.  Of this group, 106 patients died in the five years following a heart attack, with 62 of these having been diagnosed with depression and 44 had not.  In isolating the effects of the depression, researchers also considered such risk factors as smoking, hypertension, age, diabetes and gender. 

 

Some of these factors were found to lower mortality risks such as being younger and female. Diabetes and smoking had a tendency to raise the risk of death. Carney and his team used statistical methods to isolate the mortality risk associated with the various factors.  They were able to remove the influence of the various other factors from the risk factors associated with depression, to isolate the statistical impact of depression alone, in order to judge an individual's risk of dying.  Dr. Carney stated that "We found that after adjusting for those risk factors, depression continues to play a statistically significant role." 

One explanation that was given as a possibility is that depression seems to have a lingering influence on mortality due to its high level of recurrence.  Because it frequently comes and goes, it seems to have a continuing influence on the risk of death for many years subsequent to the initial heart attack.  Dr. Carney concluded that "People typically are depressed for a while, then they'll either get better with treatment or it may subside on its own."  He went on to say "But depression can always recur, and we think that because it is a recurring problem, whatever depression is doing to mortality risk after a heart attack, it continues doing for quite a long time." 

Information adapted from Clinical Depression Raises Risk of Death Fro Heart Attack Patients Years After Attack Science Daily, March 4, 2008

Information and webpage by Paul Susic  MA Licensed Psychologist   Ph.D. Candidate  (Health and Geriatric Psychologist 

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