The Puzzle of Depression and Acute Coronary Syndrome: Reviewing the Role of Acute Inflammation

Overview

Journal J Psychosom Res

Specialty Psychiatry

Date 2011 Jul 20

PMID 21767684

Citations 28

Authors

Lydia Poole

Chris Dickens

Andrew Steptoe

Affiliations

Soon will be listed here.

Abstract

The relationship between depression and coronary heart disease is well-established, but causal mechanisms are poorly understood. The aim of this review is to stimulate different ways of viewing the relationship between depression and adverse outcomes following acute coronary syndrome (ACS) and coronary artery bypass graft (CABG) surgery patients. We present an argument for depression in ACS and CABG patients being a qualitatively distinct form from that observed in psychiatric populations. This is based on three features: (1) depression developing after cardiac events has been linked in many studies to poorer outcomes than recurrent depression; (2) somatic symptoms of depression following cardiac events are particularly cardiotoxic; (3) depression following an ACS does not respond well to antidepressant treatments. We propose that inflammation is a common causal process responsible in part both for the development of depressive symptoms and for adverse cardiac outcomes, and we draw parallels with inflammation-induced sickness behaviour. Clinical implications of our observations are discussed along with suggestions for further work to advance the field.

Citing Articles

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Estimating the prevalence of depression in people with acute coronary syndromes: A systematic review and meta-analysis.

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Anticipation of High-Sensitivity C-Reactive Protein Effect on Post Myocardial Infarction Depression Disorder.

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Experience of depression in older adults with and without a physical long-term condition: findings from a qualitative interview study.

Poole L, Frost R, Rowlands H, Black G BMJ Open. 2022; 12(2):e056566.

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