Heart Patients Should Have Depression Screenings
Heart patients should be regularly screened for signs of depression because the disorder can be three times more common in heart attack survivors and those hospitalized with heart problems, The American Heart Association reported on Monday.
New recommendations published in the journal Circulation, found that only about half of heart doctors say they treat depression in their patients.
"I think we could reduce considerable suffering and improve outcomes," by screening, said Erika Froelicher, professor of nursing at the University of California, San Francisco. "I know we can do more."
Depression can result in poorer outcomes and poorer quality of life, authors said. Depressed patients may skip their medications, not change their diet or exercise or take part in rehabilitation programs.
Froelicher said there should be a concerted effort among health care providers to determine whether a heart patient is suffering from depression.
The panel suggests that heart patients be screened by first asking two standard questions: In the past two weeks, have you had little interest or pleasure in doing things? Have you felt down, depressed or hopeless?
If the patient answers yes to one or both, a questionnaire is recommended to determine if the patient is depressed and the severity. If depression is indicated, the patient may need to see a professional qualified in treating depression, the panel said, adding that treatment options include antidepressants, seeing a psychotherapist and exercise.
"Some physicians are qualified to treat it – others may be more comfortable referring the problem to a qualified mental health professional," Froelicher said.
Psychiatrist Michelle Riba said frequent screenings are important.
"What you want to see in a particular patient is how they do over time," said Riba, past president of the American Psychiatric Association, which has endorsed the heart association’s recommendations.
Dr. Mary Whooley, a professor of medicine at the University of California, San Francisco, who was not on the panel, said: "A lot of patients with depression don’t follow up on it."
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