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Treating depression may prevent recurrence of heart disease

Posted May 02 2010 12:00am - A new randomized controlled trial that examined 157 patients across five hospital sites indicates that, in people who had suffered cardiac events, it might be possible to help prevent heart disease recurrence by treating their depression symptoms.

The intervention that was tested included patient choice of psychotherapy and/or pharmacotherapy; a form of psychotherapy called problem-solving therapy; and a “stepped care” approach in which symptom severity was reviewed every eight weeks and treatment was augmented accordingly. Enhanced models of depression treatment that consider patient preference and many depression intervention options may offer an effective approach to treat depressive symptoms and improve cardiac prognosis, researchers found.

The study was led by Karina Davidson, Ph.D., the Herbert Irving Associate Professor of Medicine & Psychiatry and director of the Center for Behavioral Cardiovascular Health at Columbia University Medical Center, along with many of her colleagues at Columbia. Although this new finding is potentially very exciting, larger trials to determine the best way to manage depression and treat coronary heart disease need to be launched, according to the conclusions published in the lead article of the most recent Archives of Internal Medicine.

“In light of the damaging impact of depression on quality of life and prognosis in cardiac patients, rates of detection and effective treatment for depression remain unacceptably low in cardiac patient populations,” Dr. Davidson said. “It was in this spirit that the trial was undertaken, and our team owes much to the National Institutes of Health for recognizing the potential causal nexus between depression and heart disease, and for funding both this first trial, and a larger trial…” in the future.

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