Symptoms of depression, acute myocardial infarction, and total mortality in a community sample
Abstract
BACKGROUND: Depression has been shown to adversely affect the prognosis of patients with established coronary artery disease, but there is comparatively little evidence to document the role of depression in the initial development of coronary disease. METHODS AND RESULTS: Study participants were 409 men and 321 women who were residents of Glostrup, Denmark, born in 1914. Physical and psychological examinations in 1964 and 1974 established their baseline risk factor and disease status and their level of depressive symptomatology. Initial myocardial infarction (MI) was observed in 122 participants, and there were 290 deaths during follow-up, which ended in 1991. A 2-SD difference in depression score was associated with relative risks of 1.71 (P = .005) for MI and 1.59 (P < .001) for deaths from all causes. These findings were unchanged after we controlled for risk factors and signs of disease at baseline. There were no sex differences in effect sizes. CONCLUSIONS: High levels of depressive symptomatology are associated with increased risks of MI and mortality. The graded relationships between depression scores and risk, long-lasting nature of the effect, and stability of the depression measured across time suggest that this risk factor is best viewed as a continuous variable that represents a chronic psychological characteristic rather than a discrete and episodic psychiatric condition.
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Depressed patients with a chronic medical illness are usually sicker than their counterparts.
“Depressed patients with a chronic medical illness are usually sicker than their counterparts37–46 and have lower treatment adherence.37,47–51”
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- Authors
- Barefoot, J. C., & Schroll, M.
- Affiliations
- Glostrup Hospital (DK)
- Venue
- Circulation
- Published
- 1996-06
- Volume
- 93
- Issue
- 11
- Pages
- 1976-1980
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2016961635
- Cited by
- 850
- References
- 24
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 10 · 2023: 9 · 2022: 7 · 2021: 16 · 2020: 12 · 2019: 13 · 2018: 23 · 2017: 18 · 2016: 19 · 2015: 25 · 2014: 17 · 2013: 22 · 2012: 35
- FWCI
- 23.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5f06tw001952-03, 5r01ag009276-05)
- National Institute on Aging (AG-11268, AG-09276 5P60, P60AG011268)
- Fogarty International Center (F06 TW01952)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Keywords
- depression, depressive symptoms, acute myocardial infarction, all-cause mortality, coronary artery disease, cardiovascular risk factors, psychological risk factors, community-dwelling adults, longitudinal cohort, sex differences
- MeSH terms
- Aged, Aged, 80 and over, Cause of Death, Cross-Sectional Studies, Denmark, Depression, Female, Forced Expiratory Volume, Humans, Male, MMPI, Mortality, Myocardial Infarction, Risk, Risk Factors, Cohort Studies, Proportional Hazards Models, Survival Analysis, Myocardial Ischemia
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