Key result
Depression was associated with a fivefold higher mortality rate among myocardial infarction survivors, highlighting the need for interventions targeting psychosocial risk factors.
Effect estimate: fivefold higher
This editorial emphasizes the need to shift from observational studies documenting the adverse effects of depression and social isolation in CHD to developing interventions that address these psychosocial risk factors.
The report by Frasure-Smith et al1in the current issue ofThe Journal, showing a fivefold higher mortality rate among depressed myocardial infarction survivors, should signal, we believe, a turning point in how we think about the role of psychosocial factors in the prognosis of coronary heart disease (CHD). The new findings indicate that rather than conducting additional studies to document yet again the adverse effects of psychosocial factors on prognosis, it is now time to develop and evaluate interventions aimed at ameliorating the harmful effects of these risk factors. A considerable body of evidence already clearly documents a strong adverse impact of social isolation on prognosis in CHD patients, independently of the severity of the underlying cardiac disease.2-4Several other studies, most using retrospective designs and self-report measures of depression, have also found increased cardiac event rates in CHD patients who are depressed. In their current report
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Redford B. Williams (1993) conducted an editorial in Coronary heart disease (CHD) / Myocardial infarction. Depression and psychosocial factors was evaluated on Mortality (fivefold higher). Depression was associated with a fivefold higher mortality rate among myocardial infarction survivors, highlighting the need for interventions targeting psychosocial risk factors.
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