Depression after myocardial infarction: incidence and prognostic impact

Depressive disorder may often not be recognized or may be viewed as unavoidable concomitants of MI. The study had been carried out at the Department of Cardiology of the Zagazig University Hospital during 18 months period to assess the incidence of depression in patients in the hospital after a myocardial infarction [MI] and to study the impact of depression on cardiac mortality during one year follow up period. Our final study sample includes 191 patients with first time acute myocardial infarction. A psychiatric interview was conducted to them 7-10 days after admission. Psychiatric diagnosis based on the criteria of the Diagnostic and Statistical Manual of mental disorders, fourth edition [DSM IV]. The Beck Depression Inventory [BDI] was completed by all of them. All patients were subjected to Echo-Doppler assessment and 24 hour Holter monitoring. All patients and / or families were contacted at 12 months to determine survival status. The results showed that about [13%] of our patients met the modified DSM IV criteria for major in-hospital depression after the MI, and about [27%] had BDI scores? 10 indicative of mild to moderate symptoms of depression. There were [23] deaths during the follow up period, including [20] from cardiac causes. The results also showed that depression in hospital and depressive symptomatology were significantly related to one year cardiac mortality, and that the elevated BDI scores had ss significant prognostic impact independent of traditional post MI risk factors. Our results support the key prognostic role of depression in post-MI patients and underscore the importance of further exploring the links between the brain and the heart