Contact: Maree Hackett, Ph.D.
For Release: Immediately
Heart attacks and strokes are disturbingly common around the world: More than 32 million occur every year. And a high proportion of the survivors grapple with depression—about one out of three stroke survivors and one in four heart attack patients. That’s no minor issue, since a diagnosis of depression has been found to double a person’s risk for a repeat heart attack or stroke.
So, how many of these patients are receiving evidence-supported treatment for depression? Considerably fewer than should be treated, suggests the largest review to date of studies worldwide on depression treatment after heart attacks and strokes. Posted online ahead of print, it will appear in a forthcoming issue of Psychosomatic Medicine, journal of the Society for Biopsychosocial Science and Medicine.
The researchers looked at major scientific databases globally, considering studies that followed a total of more than 8,000 patients after strokes and more than 10,000 after heart attacks. Although 32 percent had depression after the stroke, only 24% of them used antidepressants two weeks to five years afterwards. About one out of four heart attack survivors experienced depression; 14% received antidepressants from one day to 18 months after their coronaries. Overall, depressed patients in these studies seldom received treatment with psychotherapy or self-help programs, notes Maree Hackett, Ph.D., Associate Professor and Program Head, Mental Health, at the George Institute, University of New South Wales in Sydney, Australia. Her coauthors are Simon Ladwig, M.Sc., and Katja Werheid, Ph.D.
Doctors may hesitate to prescribe antidepressants because patients already leave the hospital with an array of other pills, and possible drug interactions are a concern, she suggests. But some patients are never screened for mental health issues. Needed specialists may not be readily available to diagnose and treat. Post-heart attack patients in hospital-based studies were prescribed antidepressants more often than those based in rehab units (19% vs. 8%), perhaps because psychologists and psychiatrists are less available in these units, says Hackett. And sometimes patients may refuse to take antidepressants because they feel the pills carry a stigma, or they want to avoid common side effects. These side effects may be alleviated by switching to another pill, Hackett points out.
“But doing nothing about depression can have serious consequences,” she adds. Lack of energy, hopelessness and social withdrawal can lead to physical inactivity, dropping out of rehab, not taking medication conscientiously, a poorer quality of life and ultimately to another potentially lethal stroke or heart attack. Health professionals should reassure patients that it’s normal to feel a bit saddened after such a serious medical event, Hackett suggests. And pills are not the only way to go. Online self-help programs or psychotherapy may improve the mental health of patients with milder depressions, she says. “Yes, it’s normal to feel down afterwards. But if your symptoms persist, the wise thing to do for both your mental health and physical health is to seek treatment.”
Study Link: https://doi.org/10.1097/PSY.0000000000000632
The Society for Biopsychosocial Science and Medicine (APS) (http://www.thesbsm.org),
founded in 1942, is an international multidisciplinary academic society that conducts an annual scientific meeting and educational programs. Psychosomatic Medicine is its scientific journal. The membership of over 700 is composed of academic scientists and clinicians in medicine, psychiatry, epidemiology, health psychology and allied health services. The mission of the SBSM is “to advance and integrate the scientific study of biological, psychological, behavioral and social factors in health and disease.”