Screening and Management of Depression in Patients With Cardiovascular Disease: JACC State-of-the-Art Review

Manish K Jha; Arman Qamar; Muthiah Vaduganathan; Dennis S Charney; James W Murrough

doi:10.1016/j.jacc.2019.01.041

Screening and Management of Depression in Patients With Cardiovascular Disease: JACC State-of-the-Art Review

J Am Coll Cardiol. 2019 Apr 16;73(14):1827-1845. doi: 10.1016/j.jacc.2019.01.041.

Authors

Manish K Jha¹, Arman Qamar², Muthiah Vaduganathan³, Dennis S Charney⁴, James W Murrough⁵

Affiliations

¹ Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry, and Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York.
² TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Harvard T.H. Chan School of Public Health, Boston, Massachusetts. Electronic address: https://twitter.com/AqamarMD.
³ Heart & Vascular Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. Electronic address: https://twitter.com/mvaduganathan.
⁴ Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry, and Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York; Office of the Dean, Icahn School of Medicine at Mount Sinai, New York, New York.
⁵ Depression and Anxiety Center for Discovery and Treatment, Department of Psychiatry, and Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: james.murrough@mssm.edu.

Abstract

Depression is a common problem in patients with cardiovascular disease (CVD) and is associated with increased mortality, excess disability, greater health care expenditures, and reduced quality of life. Depression is present in 1 of 5 patients with coronary artery disease, peripheral artery disease, and heart failure. Depression complicates the optimal management of CVD by worsening cardiovascular risk factors and decreasing adherence to healthy lifestyles and evidence-based medical therapies. As such, standardized screening pathways for depression in patients with CVD offer the potential for early identification and optimal management of depression to improve health outcomes. Unfortunately, the burden of depression in patients with CVD is under-recognized; as a result, screening and management strategies targeting depression have been poorly implemented in patients with CVD. In this review, the authors discuss a practical approach for the screening and management of depression in patients with CVD.

Keywords: antidepressant treatment; cardiovascular disease; depression; screening.

Publication types

Research Support, N.I.H., Extramural
Review

MeSH terms

Cardiovascular Diseases* / prevention & control
Cardiovascular Diseases* / psychology
Depression* / diagnosis
Depression* / physiopathology
Depression* / therapy
Humans
Mass Screening / methods
Patient Care Management
Quality of Life*

Abstract

Publication types

MeSH terms

Grants and funding