Assessment and treatment of depression in patients with cardiovascular disease: National Heart, Lung, and Blood Institute Working Group Report.
OBJECTIVE
The National Heart, Lung, and Blood Institute convened an interdisciplinary working group of experts to develop recommendations for the assessment and treatment of depression in patients with coronary heart disease (CHD).


METHODS
Consensus of experts.


RESULTS
Our current recommendations are that the Beck Depression Inventory-I be employed for epidemiological studies of depression and CHD, that the Patient Health Questionnaire 2-item version be employed for screening for trial eligibility, that the Depression Interview and Structured Hamilton (DISH) be employed for diagnostic ascertainment for trial inclusion, and that the Hamilton rating scale, which is part of the DISH, be employed for both depression symptom reduction and the remission criterion in any trial. We further recommend that a randomized controlled trial be undertaken to determine whether selective serotonin reuptake inhibitors, psychotherapy, or combined treatment can reduce the risk of CHD events and mortality associated with depression in CHD patients.


CONCLUSIONS
This report summarizes the recommendations made by the working group and discusses the rationale for each recommendation, the strengths and weaknesses of alternative approaches to assessment and treatment, and the implications for future research in this area.
Davidson
Karina W
KW
Department of Medicine, Columbia University College of Physicians and Surgeons, 622 W 168th St, PH9 Center, Room 941, New York, NY 10032, USA. kd2124@columbia.edu
Kupfer
David J
DJ
Bigger
J Thomas
JT
Califf
Robert M
RM
Carney
Robert M
RM
Coyne
James C
JC
Czajkowski
Susan M
SM
Frank
Ellen
E
Frasure-Smith
Nancy
N
Freedland
Kenneth E
KE
Froelicher
Erika S
ES
Glassman
Alexander H
AH
Katon
Wayne J
WJ
Kaufmann
Peter G
PG
Kessler
Ronald C
RC
Kraemer
Helena C
HC
Krishnan
K Ranga R
KR
Lespérance
François
F
Rieckmann
Nina
N
Sheps
David S
DS
Suls
Jerry M
JM
D000928:Antidepressive Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000523:psychology*; D002986:Clinical Trials as Topic / Q000379:methods / Q000592:standards; D003131:Combined Modality Therapy; D003863:Depression / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy; D003866:Depressive Disorder / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy; D004359:Drug Therapy, Combination; D006801:Humans; D007406:Interview, Psychological; D008403:Mass Screening; D018579:Patient Selection; D011581:Psychological Tests; D011613:Psychotherapy; D012307:Risk Factors; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors