A national survey of cardiovascular physicians' beliefs and clinical care practices when diagnosing and treating depression in patients with cardiovascular disease.
A national survey was administered to determine 1) cardiovascular physicians' beliefs about the association between depression and cardiovascular disease (CVD), 2) the methods used to diagnose depression, 3) referral patterns for treatment of depression, and 4) frequency of use and preferred choice of antidepressant. A national survey of 50% of randomly selected U.S. cardiovascular physicians belonging to the American College of Cardiology was conducted; 796 of 8854 physicians who received the questionnaires responded. Cardiovascular physicians were aware of indirect associations between depression and coronary artery disease (CAD). However, 49.9% were unaware of depression as an independent cardiac risk factor; 71.2% asked less than half their patients with CAD about depression; 79% used no standard screening method to diagnose depression. Among cardiovascular physicians, 84.8% reported that between 1% and 50% of their patients have depression, and 49.2% indicated that they treat the symptoms of depression in their patients with CAD. Cardiovascular physicians often refer depressed patients with CAD to mental health professionals and recommend exercise, relaxation training, stress management, psychotherapy, and diaries for their patients. Among cardiovascular physicians, 55.5% treat depression/CAD with antidepressant medication: sertraline (28%), paroxetine (16.1%), fluoxetine (10.8%), escitalopram (8.7%), citalopram (7.9%), bupropion (4.4%), tricyclic antidepressants (3.8%), and venlafaxine 2.9%.
Feinstein
Robert E
RE
Department of Psychiatry, New York Medical College, Valhalla, New York, USA. Robert.Feinstein@uchsc.edu
Blumenfield
Michael
M
Orlowski
Barbara
B
Frishman
William H
WH
Ovanessian
Simon
S
D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D002309:Cardiology; D002318:Cardiovascular Diseases / Q000523:psychology*; D003625:Data Collection; D003866:Depressive Disorder / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D012017:Referral and Consultation; D012307:Risk Factors; D014481:United States
D000928:Antidepressive Agents