Depressed? Your cardiologist might not ask

By Julie Steenhuysen

CHICAGO (Reuters) - While depression often follows a heart attack, a recent call for heart specialists to do routine depression screening may have been premature, a team of researchers said on Monday.

Their detailed analysis of more than 17 studies suggests the American Heart Association’s recommendation for early and repeated screenings for depression in heart attack survivors would be burdensome and may not provide enough benefit to patients to justify the trouble.

They said there is little proof that depressed heart patients live longer or fare better over the long term if they are screened for depression and treated with drugs and talk therapy.

“It’s a very appealing idea that non-mental health professionals can administer a quick, easy-to-use depression screening test and that would somehow benefit patients,” said Brett Thombs of McGill University in Montreal, whose study appears in the Journal of the American Medical Association.

“Unfortunately, the reality is that it would be an extremely difficult undertaking that wouldn’t produce practical benefits for patients,” Thombs, a psychology professor, said in a statement.

Studies have shown that depression is about three times more common in patients after a heart attack and depressed patients are at higher risk for a second heart attack.

Thombs and colleagues’ review of medical studies found that screening alone or screening and referral does not help many patients and that depression treatments such as therapy or drugs result in only modest symptom relief. They found no evidence that depression treatment can prevent a second heart attack.

Dr. Sharonne Hayes, director of the Mayo Clinic’s Women’s Heart Clinic in Rochester, Minnesota, said in a telephone interview the study reflects the misgivings of cardiologists who feel they are not qualified to screen patients for depression.

“The argument this group is making is we shouldn’t be screening if we don’t have good treatment,” said Hayes, who was not involved in the study or the screening recommendations.

“I think some of the criticisms are valid. On the other hand, the take-home message that we shouldn’t even screen for depression or be looking for it in a systematic way sends the wrong message to practitioners,” she said.

(Editing by Maggie Fox and Bill Trott)


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