EFFECTS OF DEPRESSIVE-DISORDERS ON CORONARY-ARTERY DISEASE - A REVIEW

Evidence suggests that major depression and ischemic heart disease com monly co-occur and that depressive symptoms have a negative impact on cardiovascular prognosis. A Medline search was conducted to obtain art icles published between 1966 and 1996 that address the association bet ween depressive disorders and coronary artery disease. We used systema tic epidemiologic criteria to examine the strength of this association . There is convincing evidence that in patients with coronary artery d isease, depressive disorders are common and are associated with increa sed rates of morbidity and mortality. Several biological mechanisms ha ve been proposed to explain the association, including alterations in autonomic function leading to increased risk of ventricular arrhythmia s. Despite the evidence that their comorbid presence is associated wit h increased morbidity and mortality, depressive disorders in patients with coronary artery disease are often underdiagnosed and inadequately treated. At the very least, randomized treatment trials are indicated .