Depression is a significant but independent risk factor for both first heart attack and cardiovascular mortality said Padma Shri & Dr. B.C. Roy National Awardee, Dr. KK Aggarwal
, President, Heart Care Foundation of India.
Depression has been found to be associated with approximately 3-4 fold increase in the risk of subsequent cardiovascular mortality and morbidity.
The prevalence of major depression in individuals with coronary artery disease is estimated to range from 15-23%.
Treating depression can reduce the associated mortality and morbidity. But most patients with recent heart attack or unstable angina and co-morbid depression do not receive anti-depressive treatment.
Diabetes and depression often go hand in hand. Depression may be a major factor in development of Type 2 diabetes. Depression occurs in 8-22% of diabetics. Presence of diabetes displays the risk of depression.
Depression in diabetics is associated with poor sugar control, poor adherence to dietary recommendations, decreased quality of life and greater prevalence and earlier onset of multiple diabetic complications.
Treatment of depression in diabetics may improve insulin resistance and better glycemic control.
The American Heart Association (AHA) scientific advisory recommends screening for depressive symptoms in such patients.
Patients Health Questionnaire (PHQ-2) tool the provider asks the patient the following two part question:
Over the past two weeks, how often have you been bothered by any of the following problems:
- Little interest or pleasure in doing things.
- Feeling down, depressed, or hopeless.
A "yes" answer to either part should prompt the practitioner to arrange for a more comprehensive evaluation by a qualified professional to rule out depression.