Screening and Management of Depression in Patients With Cardiovascular Disease

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

doi:10.1016/j.jacc.2019.01.041

Cited by 244 publications

(169 citation statements)

References 126 publications

Supporting

Mentioning

152

Contrasting

Unclassified

Order By: Relevance

“…Since the prognosis of patients with CVD and depression associates with a 2- to fourfold higher risk of subsequent events, an effect directly proportional to the depression severity [ 9 ], the screening and management of depression are strongly recommended for patients with CVD [ 10 ]. Up to 15–20% of patients with CVD suffer from depression and two-thirds of patients with myocardial infarction (MI) develop depression either concomitant with the event or during follow-up [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Depression and cardiovascular risk—association among Beck Depression Inventory, PCSK9 levels and insulin resistance

Macchi

Favero

Ceresa

et al. 2020

Cardiovasc Diabetol

View full text Add to dashboard Cite

Background Depression and cardiovascular disease (CVD) are among the most common causes of disability in high-income countries, depression being associated with a 30% increased risk of future CV events. Depression is twice as common in people with diabetes and is associated with a 60% rise in the incidence of type 2 diabetes, an independent CVD risk factor. Proprotein convertase subtilisin/kexin type 9 (PCSK9), a key regulator of low-density lipoprotein cholesterol, has been related to a large number of CV risk factors, including insulin resistance. Aim of this study was to investigate whether the presence of depression could affect PCSK9 levels in a population of obese subjects susceptible to depressive symptoms and how these changes may mediate a pre-diabetic risk. Results In 389 obese individuals, the Beck Depression Inventory (BDI-II) was significantly associated with PCSK9 levels. For every one-unit increment in BDI-II score, PCSK9 rose by 1.85 ng/mL. Depression was associated also with the HOMA-IR (homeostatic model assessment index of insulin resistance), 11% of this effect operating indirectly via PCSK9. Conclusions This study indicates a possible mechanism linking depression and insulin resistance, a well-known CV risk factor, providing evidence for a significant role of PCSK9.

show abstract

Section: Introductionmentioning

confidence: 99%

Depression and cardiovascular risk—association among Beck Depression Inventory, PCSK9 levels and insulin resistance

Macchi

Favero

Ceresa

et al. 2020

Cardiovasc Diabetol

View full text Add to dashboard Cite

show abstract

“…Additionally, clinicians are trained on identifying the risk factors for suicide and on utilizing appropriate triage pathways based on the resources available. Such an approach is consistent with recommendations for depression screening in other medical settings, such as in patients with cardiovascular disease [65]. Also, for patients who screened positive for alcohol or drug use, providers may wish to administer the 28-item Drug Abuse Screening Test (DAST) [66] or the 24-item Michigan Alcoholism Screening Test (MAST) [67].…”

Section: Methodsmentioning

confidence: 99%

VitalSign6: A Primary Care First (PCP-First) Model for Universal Screening and Measurement-Based Care for Depression

et al. 2019

View full text Add to dashboard Cite

Major depressive disorder affects one in five adults in the United States. While practice guidelines recommend universal screening for depression in primary care settings, clinical outcomes suffer in the absence of optimal models to manage those who screen positive for depression. The current practice of employing additional mental health professionals perpetuates the assumption that primary care providers (PCP) cannot effectively manage depression, which is not feasible, due to the added costs and shortage of mental health professionals. We have extended our previous work, which demonstrated similar treatment outcomes for depression in primary care and psychiatric settings, using measurement-based care (MBC) by developing a model, called Primary Care First (PCP-First), that empowers PCPs to effectively manage depression in their patients. This model incorporates health information technology tools, through an electronic health records (EHR) integrated web-application and facilitates the following five components: (1) Screening (2) diagnosis (3) treatment selection (4) treatment implementation and (5) treatment revision. We have implemented this model as part of a quality improvement project, called VitalSign6, and will measure its success using the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework. In this report, we provide the background and rationale of the PCP-First model and the operationalization of VitalSign6 project.

show abstract

“…According to Celano and colleagues, the relationship between anxiety and CVD is a complex and unclear issue and, though no model exists, several hypotheses include both behavioral (i.e., less healthy diet, low physical activity, reduced treatment adherence and more smoking) and physiologic factors (i.e., autonomic, endothelial and platelet dysfunction and inflammation processes) as possible determinants of such comorbidity [7]. Similar to depression, despite all the existing evidences displays the link between CVD and anxiety, no systematic programs have assessed and treated anxiety in inpatients with CVD [8].…”

Section: Introductionmentioning

confidence: 99%

Depressive and Anxiety Symptoms Screening in Cardiac Inpatients: A Virtuous Italian Approach to Psychocardiology

Gorini

Giuliani

Raggio

et al. 2020

IJERPH

View full text Add to dashboard Cite

Despite the fact that American Heart Association (AHA) recommended a systematic screening for depression in cardiovascular inpatients, poor attention has been given to this issue. Furthermore, no specific guidelines exist for anxiety screening in cardiovascular inpatients. Thus, the aims of this study were to verify the feasibility of a depressive and anxiety symptoms screening protocol in an Italian hospital specializing in cardiovascular diseases and to evaluate both anxiety and depressive symptoms prevalence. A group of 2009 consecutive inpatients completed the 9-item Patient Health Questionnaire (PHQ-9) and the 7-item Generalized Anxiety Disorder (GAD-7). The rates of depressive and anxiety symptoms were almost 9% and 16% respectively. Men were less likely than women to experience both depressive and anxiety symptoms. Patients who were admitted to the heart failure unit reported higher risk of experiencing both symptoms compared to patients in other wards. Similarly, patients admitted to the cardiac surgery unit showed a higher risk of experiencing anxiety symptoms compared to other patients. The proposed screening procedure showed a good feasibility and acceptance. This study highlighted the importance of implementing a short screening procedure in hospitals dealing with cardiovascular inpatients to identify those individuals who require specific attention and interventions.

show abstract

Screening and Management of Depression in Patients With Cardiovascular Disease

Cited by 244 publications

References 126 publications

Depression and cardiovascular risk—association among Beck Depression Inventory, PCSK9 levels and insulin resistance

Depression and cardiovascular risk—association among Beck Depression Inventory, PCSK9 levels and insulin resistance

VitalSign6: A Primary Care First (PCP-First) Model for Universal Screening and Measurement-Based Care for Depression

Depressive and Anxiety Symptoms Screening in Cardiac Inpatients: A Virtuous Italian Approach to Psychocardiology

Contact Info

Product

Resources

About