"Major" Depressive Disorder, coronary heart disease, and the DSM-IV threshold problem.
Seventy-seven patients with documented coronary heart disease (CHD) were evaluated for demographic/risk factor characteristics, Major Depressive Disorder (MDD) according to the Patient's Health Questionnaire (PHQ - Diagnostic and Statistical Manual IV criteria), and emotional distress by the Symptom Checklist 90-Revised (SCL-90-R). Early age at initial diagnosis for coronary heart disease (AAID) was used as a proxy for disease malignancy because early AAID is a known predictor of early mortality. MDD was unrelated to early AAID despite being strongly associated with all the scales of the SCL-90-R. Several of the SCL-90-R scales were significantly associated with early AAID in the sample as a whole (Depression, Interpersonal Sensitivity, Anxiety, Paranoia, and Psychoticism) and after removal of the patients meeting criteria for MDD (residual N = 54). Our results suggest a new criterion for determining whether depression, or any mental disorder, is "major": onset or aggravation of serious medical illness.
Ketterer
Mark W
MW
Heart and Vascular Institute, Henry Ford Hospital & Wayne State University, Detroit MI 48202, USA. MarkWKetterer@cs.com
Wulsin
Lawson
L
Cao
J Jane
JJ
Schairer
John
J
Hakim
Arif
A
Hudson
Michael
M
Keteyian
Steven J
SJ
Khanal
Sanjay
S
Clark
Vivian
V
Weaver
W Douglas
WD
D015897:Comorbidity; D003327:Coronary Disease / Q000453:epidemiology* / Q000523:psychology; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012720:Severity of Illness Index