(Circulation. 1998;97:707-708.)
© 1998 American Heart Association, Inc.
Depression After Myocardial Infarction
Raz Gross, MD
Division of Psychiatry,
The Chaim Sheba Medical Center,
Tel Hashomer, Israel
To the Editor:
I recently reread the landmark paper by Frasure-Smith et
al,1 in which the authors showed that depression while in
the hospital after a myocardial infarction (MI) is a significant
predictor of 18-month post-MI cardiac mortality. In the abstract, the
authors wrote, "Thirty-five patients met the modified DIS criteria
for major in-hospital depression after the MI. Sixty-eight had BDI
scores >10, indicative of mild to moderate symptoms of depression."
There are no details in the article itself concerning the number of
patients who had BDI (Beck Depression Inventory) scores of 10 or more
but did not meet the DIS (Diagnostic Interview Schedule)
for major depression, ie, suffered from minor or subsyndromal
depression. Table 1 in the article suggests that among the 185
"nondepressed" patients, according to the DIS, only 6.4% have had
BDI scores of 10 or more, which makes the number that appears in the
abstract seem unlikely. Perhaps the figure 6.4% mistakenly
"shifted" from the mortality rate for the nondepressed that appears
in Table 2 in the article, which stands at 6.4%?
In view of the rapidly growing interest in the interrelations
between depression and cardiovascular
disease,2 3 4 I believe a clarification of these
important data by the authors of this seminal article is needed.
References
1.
Frasure-Smith N, Lespérance F, Talajic M.
Depression and 18-month prognosis after myocardial infarction.
Circulation. 1995;91:999–1005.
2.
Frasure-Smith N, Lespérance F, Talajic M.
Depression following myocardial infarction: impact on 6-month survival.
JAMA. 1993;270:1819–1825.
3.
Barefoot JC, Schroll M. Symptoms of depression, acute
myocardial infarction, and total mortality in a community sample.
Circulation. 1996;93:1976–1980.
4.
Pratt LA, Ford D, Crum R, Armenian HK, Gallo JJ, Eaton
WW. Depression, psychotropic medication, and risk of myocardial
infarction. Circulation. 1996;94:3123–3129.
Response
Nancy Frasure-Smith, PhD;
François Lespérance, MD;
; Mario Talajic, MD
Montreal Heart Institute,
Montreal, Quebec, Canada
Dr Gross is correct. There is a typographical error in
Table 1 of our article. The percent of patients without major
depression according to the DIS who had BDI scores 
10, indicative of
at least mild to moderate depression, should have been 22.2% (41 of
185 patients) instead of 6.4%. As Dr Gross suggests, the figure of
6.4% seems to have migrated from Table 2. We thank Dr Gross for his
careful reading and taking the time to inform us and others of the
error.
