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Am J Psychiatry 1993; 150:632-638
Copyright © 1993 by American Psychiatric Association
Course of depression in patients with hypertension, myocardial infarction, or insulin-dependent diabetes
KB Wells, W Rogers, MA Burnam and P Camp
Rand Corporation, Santa Monica, CA 90407-2138.
OBJECTIVE: The authors examined the course of depression over 2 years for
outpatients with and without a history of hypertension, a history of
myocardial infarction, or current insulin-dependent diabetes. METHOD: Among
outpatient visitors to the practices of 523 general medical clinicians and
mental health specialists, 626 depressed patients were followed for 1 or 2
years with a telephone-administered interview based on the format of the
National Institute of Mental Health Diagnostic Interview Schedule. RESULTS:
Depressed patients with and without medical illness had high rates of
persistent depressive symptoms and spells over 2 years. Patients with a
lifetime history of myocardial infarction had significantly more spells of
depression over the first follow-up year, more total symptoms of depression
in the second follow-up year, and more depressive symptoms at the end of
each follow-up year than depressed patients without myocardial infarction.
The course of depression did not differ significantly for depressed
patients with and without a lifetime history of hypertension or current
insulin-dependent diabetes. CONCLUSIONS: Among depressed adult outpatients,
a history of myocardial infarction is associated with a particularly poor
clinical prognosis. A relatively high percentage of all depressed patients
in this study had persistent depression regardless of the extent of medical
comorbidity.
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