New research from Florida State University suggests depression screening in patients with coronary artery disease (CAD) is especially crucial, because those individuals tend to have higher rates of morbidity and mortality.
“Depression in patients following a cardiac event, such as an MI, can continue for months or years after the event,” wrote co-authors Aimee Pragle, MMSc, MSPH and Susan Salahshor, PhD, of Florida State University College of Medicine in Tallahassee, in a study published in the Journal of the American Academy of Physician Assistants. “CAD and depression are diseases that significantly reduce patient quality of life and place a substantial economic burden on society.”
Patients who experience acute cardiac events and have untreated depression have impaired quality of life, increased risk of mortality and lower participation rates in cardiac rehabilitation. They are also at an increased risk of developing new cardiovascular events.
Pragle and Salahshor surveyed years of data on epidemiological and clinical factors, which suggests patients with CAD should have proactive depression screening.
“Despite this evidence, there continues to be challenges in addressing the issue,” Pragle said in a press release. “Studies show that only 30 percent of CAD patients who meet the criteria for diagnosis of major depression are actually diagnosed. This demonstrates the need for continued education of clinicians in understanding how to identify and manage depression in patients with CAD.”
The authors outlined the criteria of severe depression diagnosis and then highlighted screening tools (i.e. the Beck Depression Inventory, the Hamilton Depression Rating Scale and the Columbia Suicide Assessment Screen, among others), and recommended treatment options—including medications and psychotherapy.
"One of the first steps for effectively communicating with patients about depression and CAD is for members of the health care team to have an understanding of depression screening tools," Pragle said. "These tools should be a routine part of clinical and hospital practice."
The authors noted depressive CAD patients are less likely to comply with cardiac drug regimens or maintain preventive care initiatives to improve cholesterol, blood pressure and diet.
“Patients’ reduced ability to implement these needed health interventions can over time make them more vulnerable to worse CAD outcomes,” Pragle said.
As a senior news writer for TriMed, Subrata covers cardiology, clinical innovation and healthcare business. She has a master’s degree in communication management and 12 years of experience in journalism and public relations.