title: "Major" Depressive Disorder, coronary heart disease, and the DSM-IV threshold problem.
abstract: 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.
authors.affiliation: Heart and Vascular Institute, Henry Ford Hospital & Wayne State University, Detroit MI 48202, USA. MarkWKetterer@cs.com
authors.forename: Mark W
authors.initials: MW
authors.lastname: Ketterer
authors.forename: Lawson
authors.initials: L
authors.lastname: Wulsin
authors.forename: J Jane
authors.initials: JJ
authors.lastname: Cao
authors.forename: John
authors.initials: J
authors.lastname: Schairer
authors.forename: Arif
authors.initials: A
authors.lastname: Hakim
authors.forename: Michael
authors.initials: M
authors.lastname: Hudson
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Keteyian
authors.forename: Sanjay
authors.initials: S
authors.lastname: Khanal
authors.forename: Vivian
authors.initials: V
authors.lastname: Clark
authors.forename: W Douglas
authors.initials: WD
authors.lastname: Weaver
mesh_terms: 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