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Grand Rounds | Clinician's Corner

Depression and Cardiovascular Disease:  Healing the Broken-Hearted

Mary A. Whooley, MD
JAMA. 2006;295(24):2874-2881. doi:10.1001/jama.295.24.2874.
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Major depressive disorder is a risk factor for the development of incident coronary heart disease events in healthy patients and for adverse cardiovascular outcomes in patients with established heart disease. Depression is present in 1 of 5 outpatients with coronary heart disease and in 1 of 3 outpatients with congestive heart failure, yet the majority of cases are not recognized or appropriately treated. It is not known whether treating depression improves cardiovascular outcomes, but antidepressant treatment with selective serotonin reuptake inhibitors is generally safe, alleviates depression, and improves quality of life. This article evaluates the importance of major depression in patients with cardiovascular disease, and provides practical guidance for identifying and treating this disorder.

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Figure 1. Diagnosing Depression in Patients With Heart Disease
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Figure 2. The 9-Item Patient Health Questionnaire Depression Screening Instrument
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The PHQ-9 copyright 1999 Pfizer Inc. All rights reserved. Reproduced with permission. Use of the PHQ-9 may be made in accordance with the terms of use available at http://www.pfizer.com/pfizer/phq-9/index-jsp.

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