Despair and sadness weigh heavy on the heart.
If such feelings attain the status of clinical depression, they literally
drag down one's chances of living out the year after weathering a
heart attack, a new study finds.
Both women and men who exhibit mild to
moderate depression while hospitalized for a heart attack are more
likely to die over the subsequent year, report psychologist Nancy
Frasure-Smith of the Montreal Heart Institute in Quebec and her colleagues.
Previous research on mortality among depressed heart-attack victims
has focused largely on men (SN: 10/23/93, p. 263).
"With current cardiac treatment regimens, the prognosis after
[a heart attack] is quite good, even for depressed patients,"
the researchers assert. "[B]eyond its impact on prognosis, depression
results in considerable suffering for patients and families."
Frasure-Smith's group studied 283 women and 613 men who completed
psychiatric interviews in the hospital while undergoing treatment
for a heart attack. Most participants had not experienced more than
one heart attack.
A total of 133 women and 157 men cited symptoms of at least mild depression
while hospitalized. Most weren't treated for their depression.
Although women were twice as likely to report signs of depression
as men, the depressed members of each sex displayed roughly equal
1-year mortality rates, the scientists note in the January/February
PSYCHOSOMATIC MEDICINE. About 8 percent of depressed women and 7 percent
of depressed men died of heart-related causes in that time, compared
with slightly more than 2 percent of their nondepressed counterparts.
The researchers statistically controlled for many other influences
on mortality, including age, cigarette smoking, social isolation,
and medical problems.
Men most often reported being depressed if they lived alone and were
unmarried, Frasure-Smith's group says. In contrast, women who were
unmarried and lived by themselves had the lowest risk of depression.
Men may experience a unique closeness with their spouses, the researchers
suggest. Women maintain a wider variety of close relationships, although
from a single study it's unclear whether living alone really benefits
them after a heart attack.
In prior studies, depression raised the risk of death from heart-related
causes. Future work needs to pin down the size and source of this
effect, add psychiatrist Lawson R. Wulsin of the University of Cincinnati
and his coworkers in the same journal. -B. Bower
(2/13/97): Vol. 155, No. 7.