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November 11, 2003
FORMAL SCREENING MAY BETTER IDENTIFY DEPRESSED HEART ATTACK SURVIVORS
A formal screening program for depression among heart attack survivors might help health care providers better identify and treat the condition in this population, improving survival rates, a Johns Hopkins study suggests.
There's a belief among care providers that if depression is there, it's easy to detect, says David E. Bush, M.D., lead author of the study and an assistant professor of medicine. However, many of the signs could be missed.
"Sometimes, patients are assumed to be feeling down because of their medical illness, but if it's more than that, you're treating one thing and potentially ignoring something else," he says.
Bush and colleagues gave a standardized depression survey to 88 post-heart attack patients hospitalized at Johns Hopkins Bayview Medical Center, then
asked staff cardiovascular nurses, internal medicine residents and cardiology attending physicians to assess these patients' level of depression. Of 26 ratings of patients with a high depression score on the standardized test, staff did not correctly identify depression on seven occasions (26.9 percent). Conversely, staff ratings of 83 patients with
low depression on the standardized test were incorrectly identified as being depressed on 21 occasions (25 percent).
"Given the influence of post-heart attack depression on patient recovery, these data suggest that formal depression screening of all heart attack survivors be conducted as part of routine patient care," Bush adds. "Without formal training, health care providers failed to correctly identify depression, or lack thereof, in about one in four patients."
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Johns Hopkins' Division of Cardiology
American Heart Association - 76th Scientific Sessions