Dysthymia before myocardial infarction as a cardiac risk factor at 2.5-year follow-up.

BACKGROUND

Despite its implications for treatment strategies, the potential role of previous depression on the medical course after coronary heart disease (CHD) has not yet been thoroughly studied.

OBJECTIVE

The aim of this study was to determine whether the presence of major and minor depression, dysthymia, and demoralization in the years preceding the first myocardial infarction (MI) or angina, was associated with poor cardiac outcome at 2.5-year follow-up.

METHOD: A group of 97 consecutive patients with acute CHD, admitted to a coronary-care unit, were studied while in remission from the acute phase of CHD. Various clinical depression measures were used to assess the occurrence or recurrence of mood disorders preceding the first episode of CHD (baseline visit) and at 2.5 years after the first interview.

RESULTS

Among the variables examined as potential cardiac risk factors, only dysthymia attained statistical significance.

DISCUSSION: Further research is needed to identify an effective treatment for dysthymic patients.