Depression following myocardial infarction: a one year longitudinal study.

Abstract

The purpose of this study was to examine the course and clinical correlates of depression during the first year after myocardial infarction. A group of seventy patients hospitalized for the treatment of myocardial infarction (MI) were assessed for the presence of mood disorders during their hospital admission and at three, six, nine, and twelve months follow-up. Patients were evaluated and diagnosed using the Present State Examination and DSM-III criteria. Impairment in activities of daily living was measured by the Johns Hopkins Functioning Inventory and impairment in social functioning was measured by the Social Functioning Examination. A total of twenty-four patients met DSM-III criteria for major depression at some time during the study (18 in the acute stage, 6 during follow-up). There were two patients with minor depression (dysthymia) at intake and six developed minor depression during the follow-up period. The median duration of major depression was 4.5 months. Patients with depression at intake had greater impairment in activities of daily living than non-depressed patients. Depressions lasting more than six months were more likely to be anxious depressions than those lasting less than six months. After the acute MI period, there was a consistent relationship between the existence of depression and impaired social functioning. This is a pilot study and needs further replication due to the low rate of follow-up participation. However, these data suggest that there may be two types of depression following MI: an acute depression associated with greater functional impairment, and a prolonged depression that may be associated with inadequate social support.