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Depression and cardiac disease: epidemiology, mechanisms, and diagnosis.
Open accessAbstract
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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“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]
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“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]
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“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]
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Metadata
- 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.
- Venue
- Cardiovascular Psychiatry and Neurology
- Publisher
- Wiley
- Published
- 2013-04-07
- Volume
- 2013
- Pages
- 1-14
- ISSN
- 2090-0163 (ISSN-L)
- 2090-0171
- 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
- hybrid
- doi.org
- 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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