_____ and ______ are the 1st and 2nd cause of disease burden
CHD and depression
depression ______ risk of CHD
increases
pts w/ depression and CHD have an increase risk of
morbidity and motality
type A CHD risk
anger and hostility increased risk for CHD events
Abnormal platelet activation associated with MDD is a plausible mechanism which
depression exerts negative effects on the vascular system and increases cardiac events
SSRIs might protect against
thrombotic effects
type d
negative affect and social inhibition increased risk for CHD and cardiac events
Young women may be at high risk for _______ following Acute myocardial infarction.
depression
depression is associated with decreased adherence to _____ and 3x the risk of _____
medicine and noncompliance for treatment regimen
_____ of cardiovascular physicians report they they treat depression in their patients
50%
which 2 SSRIs are safe for CHD patients?
sertraline and citalopram
Patients with moderate to severe depression may respond better to
combination of antidepressants and psychotherapy
what percent of myocardial patients meet MDD criteria?
15-20%
Diagnostic Predictive factors for suicide
depression, substance abuse, ptsd, anxiety disorders
Opioid, _________ use , and _____ disorders are protective factors for suicidality
sedative, sleep
Suicide is the ____ leading cause of death in the US
10th
Characteristics of those who were significantly more likely to endorse suicidal ideation
comorbidities, younger age, single, AA/Black, stress disorders
Preventative suicide services what to increase
proportion of MDD patients receiving treatment and depression screenings in primary care
Preventative suicide services what to decrease
suicide rate and proportions of persons with MDD
Collaborative care intervention significantly decrease
overall depression symptoms in patients compared to usual depression care
What is collaborative care?
a multicomponent health care system intervention that uses case managers to link primary care providers, patients, and mental health professional.
What model led to the collaborative care model?
Chronic Care Model
Patients with depression and CHD failed to show that
effective treatment of depression improves cardiac outcome
systematic studies of comorbid depression and CHD are recent phenomena and lack
uniform methodology and uniform depression definition
The use of single self-report questionnaires limitations
no observational measures and are only screeners not diagnostic instruments