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Cited by 445Cardiac Health and Mental HealthAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychosomatic Disorders and Their Treatments

Depression and cardiac disease: epidemiology, mechanisms, and diagnosis.

Open access
Huffman, Jeff C., Celano, Christopher M., Beach, Scott R., Motiwala, Shweta R., Januzzi, James L.·2013·Cardiovascular Psychiatry and Neurology
DOI 10.1155/2013/695925PMC PMC3638710
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Abstract

In patients with cardiovascular disease (CVD), depression is common, persistent, and associated with worse health-related quality of life, recurrent cardiac events, and mortality. Both physiological and behavioral factors-including endothelial dysfunction, platelet abnormalities, inflammation, autonomic nervous system dysfunction, and reduced engagement in health-promoting activities-may link depression with adverse cardiac outcomes. Because of the potential impact of depression on quality of life and cardiac outcomes, the American Heart Association has recommended routine depression screening of all cardiac patients with the 2- and 9-item Patient Health Questionnaires. However, despite the availability of these easy-to-use screening tools and effective treatments, depression is underrecognized and undertreated in patients with CVD. In this paper, we review the literature on epidemiology, phenomenology, comorbid conditions, and risk factors for depression in cardiac disease. We outline the associations between depression and cardiac outcomes, as well as the mechanisms that may mediate these links. Finally, we discuss the evidence for and against routine depression screening in patients with CVD and make specific recommendations for when and how to assess for depression in this high-risk population.

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  • There is a lack of easily accessible evidence-based treatments for patients with mental disorders following cardiovascular events.

    “Yet, there is a lack of easily accessible evidence-based treatments.”

    From Metacognitive Short-Term Intervention in Patients With Mental Disorders Following Cardiovascular Events (2022) · cites this paper as [5]

    Section 8, “Identification of Depression in Cardiac Patients” (page unavailable), says depression in cardiac patients is underrecognized and undertreated; Section 9 says screening should occur only when there is a clear path to treatment. This supports concern about patients obtaining care, but not a general lack of easily accessible evidence-based treatments. The paper explicitly says safe and effective medication and psychotherapy are available for cardiac patients with major depressive disorder. (LLM, conf=0.83)

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  • In clinical practice, only a fraction of CVD patients with a comorbid mental illness actually receives an adequate psychological treatment.

    “In clinical practice, only a fraction of CVD patients with a comorbid mental illness actually receives an adequate psychological treatment (5, 17, 18).”

    From Metacognitive Short-Term Intervention in Patients With Mental Disorders Following Cardiovascular Events (2022) · cites this paper as [5]

    Section 8, “Identification of Depression in Cardiac Patients” (page unavailable), says depression is undertreated in cardiac patients and reports that only 11% of depressed post-MI patients received antidepressants. That supports the claim’s general point about limited treatment, but the paper does not establish the proportion receiving adequate psychological treatment or extend that finding to all comorbid mental illnesses. (LLM, conf=0.85)

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  • The most common disorders among CVD patients are pathological stress reactions after a cardiovascular event, depressive and anxiety disorders.

    “The most common disorders among CVD patients are pathological stress reactions after a cardiovascular event, depressive and anxiety disorders (3–6).”

    From Metacognitive Short-Term Intervention in Patients With Mental Disorders Following Cardiovascular Events (2022) · cites this paper as [5]

    Section 2 describes depression as highly prevalent in cardiac patients, and Section 5 says anxiety disorders are frequently seen. Section 5 also reports posttraumatic stress disorder in specific groups, particularly CABG and ICD patients, but does not establish that pathological stress reactions are among the most common disorders across all CVD patients. The paper does not establish the claimed ranking of these disorders. (LLM, conf=0.85)

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Authors
Huffman, J. C., Celano, C. M., Beach, S. R., Motiwala, S. R., & Januzzi, J. L.
Affiliations
Harvard University (US)
Corresponding author
Huffman, Jeff C.
ORCID
Venue
Cardiovascular Psychiatry and Neurology
Publisher
Wiley
Published
2013-04-07
Volume
2013
Pages
1-14
ISSN
  • 2090-0163 (ISSN-L)
  • 2090-0171
DOI
10.1155/2013/695925
PMC
PMC3638710
OpenAlex
W2160660885
Cited by
445
References
176
Citations by year
2026: 19 · 2025: 26 · 2024: 26 · 2023: 71 · 2022: 29 · 2021: 30 · 2020: 64 · 2019: 37 · 2018: 30 · 2017: 29 · 2016: 32 · 2015: 25 · 2014: 21 · 2013: 6
FWCI
19.05
Type
journal article
Language
en
Open access
Licence
Locations
  • Cardiovascular Psychiatry and Neurology (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
Funders
National Heart, Lung, and Blood Institute (R01HL113272)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Keywords
depression, cardiovascular disease, comorbidities, depression screening, Patient Health Questionnaire, endothelial dysfunction, platelet abnormalities, inflammation, autonomic dysfunction, health behavior, cardiac outcomes, mortality, quality of life, risk factors

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