Journal
JOURNAL OF PSYCHIATRIC RESEARCH
Volume 42, Issue 8, Pages 670-675Publisher
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.jpsychires.2007.07.004
Keywords
acute coronary syndrome; coronary artery disease; myocardial infarction; angiogram; incident major depressive disorder; recurrent major depressive disorder
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Funding
- NCRR NIH HHS [TL1 RR024158, TL1 RR024158-02] Funding Source: Medline
- NHLBI NIH HHS [R01 HL080665, R24 HL076857, N01HC25197, K24 HL084034, K24 HL084034-02, N01 HC025197, HL-076857, R01 HL080665-02, R24 HL076857-04, HC-25197, HL-04458, K23 HL004458] Funding Source: Medline
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There is recent evidence that acute coronary syndrome (ACS) patients with first time incident major depressive disorder (MDD) and those with recurrent MDD represent different subtypes among individuals with ACS and comorbid depression. However, few studies have examined whether or not these subtypes differ in coronary artery disease (CAD) severity. We assessed whether those with incident MDD (in-hospital MDD and negative for history of MDD) or recurrent MDD (in-hospital MDD and a positive history of MDD) differ in angiographically documented CAD severity. Within 1 week of admission for ACS, 88 patients completed a clinical interview to assess current and past diagnosis of MDD. CAD severity was assessed in all patients by coronary angiography. A hierarchical regression analysis showed that neither in-hospital MDD status, nor history of MDD were significant predictors of CAD severity, but the interaction term between in-hospital MDD status and history of MDD was a significant predictor of CAD severity, after controlling for age, sex and ethnicity. Follow-up analyses showed that patients with first time, incident MDD had significantly more severe CAD compared to patients with recurrent MDD (p = 0.043). To conclude, our study adds to the growing evidence that patients with incident MDD should be considered as a clinically distinct subtype from those with recurrent MDD. Possible mechanisms for differing CAD severity by angiogram between these two subtypes are proposed and implications for prognosis and treatment are discussed. (C) 2007 Elsevier Ltd. All rights reserved.
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