Older patients' views on the relationship between depression and heart disease.
OBJECTIVE
Longitudinal studies have found evidence of associations between coronary heart disease and clinical depression. We sought to understand older patients' views regarding relationships between depression and heart disease to facilitate patient-provider communication about heart disease and depression and to lay the groundwork for designing interventions.


METHODS
The design was a qualitative study using semi-structured interviews. In all, 33 primary care patients 65 years and over with dysphoria, anhedonia, hopelessness, worthlessness, or sleep disturbance who were taking at least one medication targeting cardiovascular risk factors were interviewed in the office of their primary care clinician. Participants were asked open-ended questions about depression and heart disease and their treatment. A multidisciplinary research team coded the transcripts and identified key themes.


RESULTS
Participants gave clear descriptions of how heart disease can lead to depression and depression can lead to heart disease. Participants supported treating depression immediately in the context of heart disease and generally preferred integrated care.


CONCLUSIONS
Depression treatment may be more acceptable if discussed in terms of overall cardiovascular risk. Our results support the integration of depression management with management for risk factors for cardiovascular disease.
Bogner
Hillary R
HR
Department of Family Medicine and Community Health, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA. hillary.bogner@uphs.upenn.edu
Dahlberg
Britt
B
de Vries
Heather F
HF
Cahill
Eileen
E
Barg
Frances K
FK
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003863:Depression / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D015577:Geriatric Assessment; D007722:Health Knowledge, Attitudes, Practice; D006331:Heart Diseases / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010348:Patient Care Team; D011320:Primary Health Care; D011581:Psychological Tests; D011594:Psychometrics; D036301:Qualitative Research; D012307:Risk Factors; D014481:United States / Q000453:epidemiology