Relative lack of depressive cognitions in post-myocardial infarction depression

BackgroundDepression has been associated with adverse clinical events in myocardial infarction (MI) patients, but many questions about the nature of post-MI depression remain unanswered. We examined whether depressive cognitions characteristic of depression in psychiatric patients are also present in post-MI patients with major depression (MD).MethodsNon-depressed (n = 40) and depressed (n = 40) post-MI patients, and psychiatric outpatients (n = 40) treated for clinical depression, matched on age and sex, were interviewed using a structured clinical interview to diagnose DSM-IV MD. All patients also completed the Beck Depression Inventory (BDI) and the Beck Cognition Checklist-Depression subscale (CCL-D).ResultsMean levels of depressive cognitions were considerably higher in depressed psychiatric patients compared with depressed post-MI patients (34.9 versus 28.0; p = .013), and higher in depressed post-MI patients compared with non-depressed post-MI patients (28.0 versus 17.8; p < .0001), adjusted for age, sex, educational level, and marital status. Younger age (p = .024), absence of a partner (p = .016) and depressed psychiatric status (p = .016) were independently associated with depressive cognitions. Psychiatric patients also had higher mean levels of depressive symptoms as compared to depressed post-MI patients (25.1 versus 17.8; p = .001).LimitationsThis study is based on a cross-sectional design.ConclusionsThe symptom presentation of MD in post-MI patients is both quantitatively and qualitatively different from that seen in psychiatric patients, suggesting that depressive symptoms in post-MI patients differ in content from those in psychiatric patients. These findings could have important consequences for the design and contents of therapeutic programs for treating depression in post-MI patients.