The findings beg another question: Should cardiologists be screening heart failure patients for depression, or doing anything if they uncover it? The availability of a quick and easy-to-administer depression test points to yes, the authors said. “It is feasible for the cardiologist to assess patients regularly for depression. There are validated and brief screening instruments that can facilitate rapid identification of patients with depressive symptoms.”
One is as simple as asking two questions. “Over the past 2 weeks, have you been bothered by any of the following problems: 1) Feeling little interest or pleasure in doing things? 2) Feeling down, depressed or hopeless?”
If a patient answers yes to either one, the cardiologist might wish to further investigate, or refer the patient for treatment.
Finally, noted Dr. Connerney and Dr. Shapiro, there really is no way the study can answer the question of reverse causality. “Multiple physiological and behavioral mechanisms may underlie the association between depression and mortality,” they wrote. Further studies are needed of the relationship between the course of depression and mortality in heart failure patients, the mechanisms linking depression to adverse outcomes, and the effects of depression intervention.”
DR. CONNERNEY is the senior director of Quality, Safety, and Clinical Effectiveness at the University of Maryland Medical Center in Baltimore. DR. SHAPIRO is professor of clinical psychiatry at the New York Presbyterian Hospital–Columbia University Medical Center. Both reported that they had no relationships to disclose.