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


METHODS
MEDLINE, Cochrane, CINAHL, PsycINFO, and EMBASE.


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 > or =10 was 31.1% (CI 29.2% to 33.0%; N=2,273, 6 studies), using a Hospital Anxiety and Depression Scale (HADS) score > or =8%, 15.5% (CI 13.2% to 18.0%; N=863, 4 studies), and with a HADS score > or =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.
Thombs
Brett D
BD
Johns Hopkins University Evidence-based Practice Center, Johns Hopkins University School of Medicine, Baltimore, Md, USA.
Bass
Eric B
EB
Ford
Daniel E
DE
Stewart
Kerry J
KJ
Tsilidis
Konstantinos K
KK
Patel
Udita
U
Fauerbach
James A
JA
Bush
David E
DE
Ziegelstein
Roy C
RC
D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D006760:Hospitalization; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications / Q000523:psychology*; D015995:Prevalence