DEPRESSION FOLLOWING MYOCARDIAL-INFARCTION - A ONE-YEAR LONGITUDINAL-STUDY

Objective: The purpose of this study was to examine the course and cli nical correlates of depression during the first year after myocardial infarction. Method: A group of seventy patients hospitalized for the t reatment of myocardial infarction (MI) were assessed for the presence of mood disorders during their hospital admission and at three, six, n ine, and twelve months follow-up. Patients were evaluated and diagnose d using the Present State Examination and DSM-III criteria. Impairment in activities of daily living was measured by the Johns Hopkins Funct ioning Inventory and impairment in social functioning was measured by the Social Functioning Examination. Results: A total of twenty-four pa tients met DSM-III criteria for major depression at some time during t he study (18 in the acute stage, 6 during follow-up). There were two p atients with minor depression (dysthmia) at intake and six developed m inor depression during the follow-up period. The median duration of ma jor depression was 4.5 months. Patients with depression at intake had greater impairment in activities of daily living than non-depressed pa tients. Depressions lasting more than six months were more likely to b e anxious depressions than those lasting less than six months. After t he acute MI period, there was a consistent relationship between the ex istence of depression and impaired social functioning. Conclusions: Th is is a pilot study and needs further replication due to the low rate of follow-up participation. However, these data suggest that there may be two types of depression following MI: an acute depression associat ed with greater functional impairment, and a prolonged depression that may be associated with inadequate social support.