Depression and Cardiovascular Disease

Depressive disorder occurs frequently in response to the onset of several cardiovascular diseases, particularly in the post-myocardial infarction period, and can become an important determinant of prognosis or recovery. In patients whose heart disease or hypertension is managed by a cardiologist or primary care physician, depressive disorder is apt to go undiagnosed and therefore untreated. The Self-rating Depression Scale (SDS) and/or Mini-International Neuropsychiatric Interview (MINI) have been proposed as simple, useful diagnostic questionnaires for use in such patients. In the relationship between depressive disorder and cardiovascular diseases, the “physical or mental exhaustion” that can occur under depression seems to bear a great deal of responsibility for the onset or prognosis of cardiovascular diseases, because the pathophysiological features of depressive disorder closely resemble those of an exhausted human or animal. Selective serotonin reuptake inhibitors (SSRIs) appear to be a safe form of treatment for depressive disorder, especially in patients with preexisting cardiovascular diseases. However, the prevention of depressive disorder might be even more important, by preventing patients from falling into the exhausted state.