Depression and related psychological factors in heart disease.

In this article we review the role of depression and other related psychological factors in heart disease. The prevalence of heart disease in patients with depression is high, and epidemiological links between depression and heart disease are evident in studies of community samples, psychiatric patients, and heart disease patients. We also describe the links between heart disease and related psychological factors-including vital exhaustion, Type A behavior pattern, anger and hostility, and Type D personality-and summarize proposed mechanisms that may link negative affects with heart disease. Finally, we review treatment of depression in heart disease, including evidence from several large clinical trials.