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.
- Copyright © 1998 by American Heart Association
Frasure-Smith N, Lespérance F, Talajic M. Depression and 18-month prognosis after myocardial infarction. Circulation. 1995;91:999–1005.
Frasure-Smith N, Lespérance F, Talajic M. Depression following myocardial infarction: impact on 6-month survival. JAMA. 1993;270:1819–1825.
Barefoot JC, Schroll M. Symptoms of depression, acute myocardial infarction, and total mortality in a community sample. Circulation. 1996;93:1976–1980.
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.
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.