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Prevalence of depression in survivors of acute myocardial infarction

Review of the evidence

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Abstract

OBJECTIVES: To assess the prevalence and persistence of depression in patients with acute myocardial infarction (AMI) and the relationship between assessment modality and prevalence.

DATA SOURCES: MEDLINE®, Cochrane, CINAHL®, PsycINFO®, and EMBASE®.

REVIEW METHODS: A comprehensive search was conducted in March 2004 to identify original research studies published since 1980 that used a standardized interview or validated questionnaire to assess depression. The search was augmented by hand searching of selected journals from October 2003 through April 2004 and references of identified articles and reviews. Studies were excluded if only an abstract was provided, if not in English, or if depression was not measured by a validated method.

RESULTS: Major depression was identified in 19.8% (95% confidence interval [CI] 19.1% to 20.6%) of patients using structured interviews (N=10,785, 8 studies). The prevalence of significant depressive symptoms based on a Beck Depression Inventory score ≥10 was 31.1% (CI 29.2% to 33.0%; N=2,273, 6 studies), using a Hospital Anxiety and Depression Scale (HADS) score ≥8%, 15.5% (CI 13.2% to 18.0%; N=863, 4 studies), and with a HADS score ≥11%, 7.3% (CI 5.5% to 9.3%; N=830, 4 studies). Although a significant proportion of patients continued to be depressed in the year after discharge, the limited number of studies and variable follow-up times precluded specification of prevalence rates at given time points.

CONCLUSIONS: Depression is common and persistent in AMI survivors. Prevalence varies depending on assessment method, likely reflecting treatment of somatic symptoms.

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Authors and Affiliations

  1. Johns Hopkins University Evidence-based Practice Center, Johns Hopkins University School of Mediicine, Baltimore, Md, USA

    Brett D. Thombs PhD, Eric B. Bass MD, MPH, Daniel E. Ford MD, Kerry J. Stewart ED, Konstantinos K. Tsilidis MPH, Udita Patel MPH, James A. Fauerbach PhD, David E. Bush MD &  Roy C. Ziegelstein MD

  2. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Md, USA

    Brett D. Thombs PhD, Daniel E. Ford MD & James A. Fauerbach PhD

  3. Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md, USA

    Eric B. Bass MD, MPH, Daniel E. Ford MD, Kerry J. Stewart ED, David E. Bush MD &  Roy C. Ziegelstein MD

  4. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md, USA

    Eric B. Bass MD, MPH, Daniel E. Ford MD & Konstantinos K. Tsilidis MPH

  5. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md, USA

    Eric B. Bass MD, MPH & Daniel E. Ford MD

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  1. Brett D. Thombs PhD
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Correspondence to Roy C. Ziegelstein MD.

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The authors have no conflicts of interest to report.

This article is based on research conducted by the Johns Hopkins University Evidence-based Practice Center under contract to the Agency for Healthcare Research and Quality (Contract No. 290-02-0018), Rockville, Md. The authors of this article are responsible for its contents, including any clinical or treatment recommendations. No statement in this article should be construed as an official position of the Agency for Healthcare Research and Quality or of the U.S. Department of Health and Human Services.

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Thombs, B.D., Bass, E.B., Ford, D.E. et al. Prevalence of depression in survivors of acute myocardial infarction. J GEN INTERN MED 21, 30–38 (2006). https://doi.org/10.1111/j.1525-1497.2005.00269.x

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  • DOI: https://doi.org/10.1111/j.1525-1497.2005.00269.x

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