By Alan Mozes
People who’ve been hospitalized for heart problems appear to suffer less depression and anxiety in the weeks and months after discharge if they participate in a basic depression management program before leaving the hospital, a new study suggests.
“This is important because depression is common in heart disease patients, and it has been linked to more re-hospitalizations and higher death rates,” noted the study’s lead author, Dr. Jeff C. Huffman, an assistant professor of psychiatry at Harvard Medical School and director of the Cardiac Psychiatry Research Program at Massachusetts General Hospital in Boston.
“However, most cardiac patients have their depression go unrecognized and untreated,” Huffman added. “A program like the one studied could identify depression in hospitalized heart patients and help them to not only get treatment for their heart disease but also treatment for the depression that could impair their recovery.”
The findings were reported online March 7 in Circulation: Cardiovascular Quality and Outcomes.
The American Heart Association recommends depression screening for heart disease patients and, for those diagnosed with the condition, some type of coordinated treatment, the authors noted. But, they said, typical in-hospital intervention involves nothing more than a recommendation to seek mental health treatment upon discharge. Most in-depth depression management programs are limited to outpatient settings.
To explore the potential of an in-hospital collaborative care program, Huffman and his fellow researchers focused on 175 people on the verge of being discharged from a hospital after treatment for acute coronary syndrome, arrhythmia or heart failure. They were screened for depression and then randomly assigned to receive either standard care or to participate in a depression management program.
In the program, a psychiatrist developed individualized treatment recommendations and, together with the patient’s other doctors, coordinated prescriptions and therapy referrals. Care managers — who were not doctors — acted as facilitators between the patients, their doctors and the psychiatrist. They provided educational material on depression, including treatment options, to the participants, and helped them schedule “pleasurable activities.” Care managers also coordinated inpatient and outpatient care, based on the psychiatrist’s and medical doctors’ guidelines. Continue Reading
