OBJECTIVE: Depression is associated with an increased risk of mortality in patients with coronary heart disease (CHD). The risk may be reduced in patients who remit with adequate treatment, but few patients achieve complete remission. The purpose of this study was to identify the symptoms that persist despite aggressive treatment for depression in patients with CHD. METHODS: One hundred twenty-five patients with stable CHD who met the DSM-IV criteria for a moderate-to-severe major depressive episode completed treatment with cognitive behavior therapy, either alone or combined with an antidepressant, for up to 16 weeks. Depression symptoms were assessed at baseline and after 16 weeks of treatment. RESULTS: The M (SD) Beck Depression Inventory scores were 30.0 (8.6) at baseline and 8.3 (7.5) at 16 weeks. Seventy seven (61%) of the participants who completed treatment met remission criteria (Hamilton Rating Scale for Depression ≤7) at 16 weeks. Loss of energy and fatigue were the most common posttreatment symptoms both in remitters (n = 44, 57%; n = 34, 44.2%) and nonremitters (n = 42, 87.5%; n = 35, 72.9%). These symptoms were not predicted by baseline depression severity, anxiety, demographic, or medical variables including inflammatory markers or cardiac functioning or by medical events during depression treatment. CONCLUSIONS: Fatigue and loss of energy often persist in patients with CHD even after otherwise successful treatment for major depression. These residual symptoms may increase the risks of relapse and mortality. Development of effective interventions for these persistent symptoms is a priority for future research.
OBJECTIVE:Depression is associated with an increased risk of mortality in patients with coronary heart disease (CHD). The risk may be reduced in patients who remit with adequate treatment, but few patients achieve complete remission. The purpose of this study was to identify the symptoms that persist despite aggressive treatment for depression in patients with CHD. METHODS: One hundred twenty-five patients with stable CHD who met the DSM-IV criteria for a moderate-to-severe major depressive episode completed treatment with cognitive behavior therapy, either alone or combined with an antidepressant, for up to 16 weeks. Depression symptoms were assessed at baseline and after 16 weeks of treatment. RESULTS: The M (SD) Beck Depression Inventory scores were 30.0 (8.6) at baseline and 8.3 (7.5) at 16 weeks. Seventy seven (61%) of the participants who completed treatment met remission criteria (Hamilton Rating Scale for Depression ≤7) at 16 weeks. Loss of energy and fatigue were the most common posttreatment symptoms both in remitters (n = 44, 57%; n = 34, 44.2%) and nonremitters (n = 42, 87.5%; n = 35, 72.9%). These symptoms were not predicted by baseline depression severity, anxiety, demographic, or medical variables including inflammatory markers or cardiac functioning or by medical events during depression treatment. CONCLUSIONS:Fatigue and loss of energy often persist in patients with CHD even after otherwise successful treatment for major depression. These residual symptoms may increase the risks of relapse and mortality. Development of effective interventions for these persistent symptoms is a priority for future research.
Authors: A A Nierenberg; B R Keefe; V C Leslie; J E Alpert; J A Pava; J J Worthington; J F Rosenbaum; M Fava Journal: J Clin Psychiatry Date: 1999-04 Impact factor: 4.384
Authors: C Beard; A J Millner; M J C Forgeard; E I Fried; K J Hsu; M T Treadway; C V Leonard; S J Kertz; T Björgvinsson Journal: Psychol Med Date: 2016-09-14 Impact factor: 7.723
Authors: D E Bush; R C Ziegelstein; M Tayback; D Richter; S Stevens; H Zahalsky; J A Fauerbach Journal: Am J Cardiol Date: 2001-08-15 Impact factor: 2.778
Authors: L L Judd; H S Akiskal; J D Maser; P J Zeller; J Endicott; W Coryell; M P Paulus; J L Kunovac; A C Leon; T I Mueller; J A Rice; M B Keller Journal: J Affect Disord Date: 1998-09 Impact factor: 4.839
Authors: Peter de Jonge; Adriaan Honig; Joost P van Melle; Aart H Schene; Astrid M G Kuyper; Dorien Tulner; Annique Schins; Johan Ormel Journal: Am J Psychiatry Date: 2007-09 Impact factor: 18.112
Authors: Venkatramanujan Srinivasan; Amnon Brzezinski; Seithikurippu R Pandi-Perumal; D Warren Spence; Daniel P Cardinali; Gregory M Brown Journal: Prog Neuropsychopharmacol Biol Psychiatry Date: 2011-03-29 Impact factor: 5.067