title: A topographical map of the causal network of mechanisms underlying the relationship between major depressive disorder and coronary heart disease.
abstract: OBJECTIVE
  Major depressive disorder (MDD) and coronary heart disease (CHD) are both clinically important public health problems. Depression is linked with a higher incidence of ischaemic cardiac events and MDD is more prevalent in patients with CHD. No single comprehensive model has yet described the causal mechanisms linking MDD to CHD. Several key mechanisms have been put forward, comprising behavioural mechanisms, genetic mechanisms, dysregulation of immune mechanisms, coagulation abnormalities and vascular endothelial dysfunction, polyunsaturated omega-3 free fatty acid deficiency, and autonomic mechanisms. It has been suggested that these mechanisms form a network, which links MDD and CHD. The aim of this review is to examine the causal mechanisms underlying the relationship between MDD and CHD, with the aim of constructing a topological map of the causal network which describes the relationship between MDD and CHD.
  
  
  METHODS
  The search term 'depression and heart disease' was entered into an electronic multiple database search engine. Abstracts were screened for relevance and individually selected articles were collated.
  
  
  RESULTS
  This review introduces the first topological map of the causal network which describes the relationship between MDD and CHD.
  
  
  CONCLUSIONS
  Viewing the causal pathways as an interdependent network presents a new paradigm in this field and provides fertile ground for further research. The causal network can be studied using the methodology of systems biology, which is briefly introduced. Future research should focus on the creation of a more comprehensive topological map of the causal network and the quantification of the activity between each node of the causal network.
authors.affiliation: School of Psychology and Griffith Health Institute, Griffith University, Southport, Queensland 4215, Australia. Chris_Stapelberg@health.qld.gov.au
authors.forename: Nicolas J C
authors.initials: NJ
authors.lastname: Stapelberg
authors.forename: David L
authors.initials: DL
authors.lastname: Neumann
authors.forename: David H K
authors.initials: DH
authors.lastname: Shum
authors.forename: Harry
authors.initials: H
authors.lastname: McConnell
authors.forename: Ian
authors.initials: I
authors.lastname: Hamilton-Craig
mesh_terms: D001342:Autonomic Nervous System Diseases / Q000150:complications / Q000503:physiopathology; D003327:Coronary Disease / Q000150:complications / Q000503:physiopathology*; D003865:Major Depressive Disorder / Q000150:complications / Q000503:physiopathology*; D005231:Fatty Acids, Unsaturated / Q000502:physiology; D020022:Genetic Predisposition to Disease; D006402:Hematologic Diseases / Q000150:complications / Q000503:physiopathology; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D007107:Immune System / Q000503:physiopathology; D008954:Models, Biological; D008960:Models, Psychological; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D012307:Risk Factors
chemical_list: D005231:Fatty Acids, Unsaturated