Study Questions Screening Heart Attack Patients for Depression

Nov. 12 -- TUESDAY, Nov. 11 (HealthDay News) -- There's not enough evidence to support a recent American Heart Association (AHA) call to automatically screen heart patients for depression, according to international experts who contend the "premature" recommendation would consume a vast amount of resources without any proof it would improve patient care.

About 80 million Americans have some form of heart disease. The AHA believes there's an important link between depression and cardiac care, and estimates that 25 percent of heart attack patients experience feelings of sadness and develop a gloomy outlook due to their heart troubles. Some studies suggest that depression more than doubles the risk of death.

Screening heart patients for depression would involve use of a questionnaire and other tests to try to identify those who may be depressed, even though they may have no history or clinical indications of depression.

However, researchers from Johns Hopkins University in Baltimore, McGill University in Montreal, and six other institutions from around the world analyzed the findings of 1,500 clinical trials (including 17 selected for detailed review) and concluded there was no scientific proof for the AHA's "massive, expensive and labor-intensive" proposal.

The researchers' conclusions are published in the Nov. 12 special edition of the Journal of the American Medical Association, which coincides with the AHA's annual scientific sessions in New Orleans.

"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. Unfortunately, the reality is that it would be an extremely difficult undertaking that wouldn't produce practical benefits for patients," study team leader Brett Thombs, a psychologist and assistant professor in the department of psychiatry at McGill, said in a university news release.

"We discovered that screening alone or screening and referral doesn't help patients. This is true even in primary care, where the doctor is usually better trained than a cardiologist to manage depression," Thombs said. "We see positive effects only in 'enhanced care' or 'collaborative care' environments where they have mental health specialists on call. And even there, we only see tiny effects."