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June 13, 2005

Screening for Depression: This Is the Heart of the Matter

Arch Intern Med. 2005;165(11):1214-1215. doi:10.1001/archinte.165.11.1214

You ought not to attempt to cure the body without the soul. The cure of many diseases is unknown to physicians because they disregard the whole. Hippocrates

Despite Hippocrates’ advice, few clinicians and researchers have suspected that psychological problems may be among the most important modifiable risk factors for medical morbidity and mortality. There is growing evidence that this could be the case. Many cardiac patients (30%-45%) experience clinically important depressive symptoms.1 The impact of depression on cardiac outcomes is at least as important as a history of myocardial infarction and left ventricular dysfunction.2 Depression is related to onset of cardiac disease; it is associated with higher medical costs; and it reduces patients’ quality of life and compliance with treatment.3-5 The cardiovascular prognosis is linked to the severity of depressive symptoms6: risk increases along with symptom severity whether or not the patient meets diagnostic criteria for a depressive disorder.7

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