The British Journal of Psychiatry (2007) 190: 272-273. doi: 10.1192/bjp.190.3.272b
© 2007 The Royal College of Psychiatrists
This Article
Right arrow Full Text (PDF)
Right arrow Submit an eLetter
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by de Jonge, P.
Right arrow Articles by Ormel, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by de Jonge, P.
Right arrow Articles by Ormel, J.

Correspondence

Depression and anxiety after myocardial infarction

P. de Jonge

Department of Internal Medicine and Department of Psychiatry, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, Groningen, The Netherlands. Email: Peter.de.Jonge{at}med.umcg.nl

J. Ormel

Department of Psychiatry, University Medical Centre Groningen, The Netherlands

EDITED BY KIRIAKOS XENITIDIS and COLIN CAMPBELL

Dickens et al (2006) stress the importance of detection and treatment of anxiety and depression for quality of life after myocardial infarction and point to the mediating role of energy and fatigue.

We agree that depression following myocardial infarction predicts long-term quality of life and we recently showed that this effect persists after controlling for cardiac condition and quality of life at 3 months post-myocardial infarction (de Jonge et al, 2006). However, it is unclear whether and how detection and treatment of depression can counter these effects. In the SADHART study Glassman et al (2002) found that the effects of sertraline were modest and appeared to be restricted to depression with an onset before the infarction, but Dickens et al found that depression and anxiety which were present before myocardial infarction did not predict quality of life. In the ENRICHD trial (Berkman et al, 2003), cognitive–behavioural therapy had modest effects on depressive symptoms at 6 months post-infarction in patients with depression and social isolation, but these effects diminished over time. In the EXIT trial (Appels et al, 2005), where the focus of treatment was explicitly on vital exhaustion, only some intervention effects were observed and these were modified by the presence of a previous cardiac history.

We agree with Dickens et al that there is a need for improved detection and treatment of depression and anxiety following myocardial infarction but several questions need to be addressed. These include `can the effects of depression and anxiety be linked to specific subgroups of emotional disorders based on symptoms and/or onset?; `can interventions that were developed in general psychiatry be applied to depression post-myocardial infarction or should they be adapted?'; and `how can psychiatric interventions be integrated into regular cardiac aftercare?'

REFERENCES

  1. Appels, A., Bar, F., van der Pol, G., et al (2005) Effects of treating exhaustion in angioplasty patients on new coronary events: results of the randomized Exhaustion Intervention Trial (EXIT). Psychosomatic Medicine, 67, 217 -223.[Abstract/Free Full Text]
  2. Berkman, I. F., Blumenthal, I., Burg, M., et al (2003) 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, 289, 3106 -3116.[Abstract/Free Full Text]
  3. de Jonge, P., Spijkerman, T. A., van den Brink, R. H. S., et al (2006) Depression following myocardial infarction is a risk factor for declined health-related quality of life and increased disability and cardiac complaints at 12 months. Heart, 92, 32-39.[Abstract/Free Full Text]
  4. Dickens, C. M., McGowan, L., Percival, C., et al (2006) Contribution of depression and anxiety to impaired health-related quality of life following first myocardial infarction. British Journal of Psychiatry, 189, 367 -372.[Abstract/Free Full Text]
  5. Glassman, A. H., O'Connor, C. M., Califf, R. M., et al (2002) Sertraline treatment of major depression in patients with acute MI or unstable angina. JAMA, 288, 701 -709.[Abstract/Free Full Text]



This article has been cited by other articles:


Home page
 Am J Crit CareHome page
J.-A. Eastwood, L. Doering, J. Roper, and R. D. Hays
Uncertainty and Health-Related Quality of Life 1 Year After Coronary Angiography
Am. J. Crit. Care., May 1, 2008; 17(3): 232 - 242.
[Abstract] [Full Text] [PDF]

This Article
Right arrow Full Text (PDF)
Right arrow Submit an eLetter
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by de Jonge, P.
Right arrow Articles by Ormel, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by de Jonge, P.
Right arrow Articles by Ormel, J.