Reflections on depression as a cardiac risk factor
Reflections on depression as a cardiac risk factor
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DOI：
10.1097/01.psy.0000162253.07959.db
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发表时间：
2005-05-01
影响因子：
3.3
通讯作者：
Lesperance, F
中科院分区：
文献类型：
--
作者：
Frasure-Smith, N;Lesperance, F
目的：北美主要的心脏病学组织目前没有将抑郁列为正式确认的心脏危险因素，但许多行为医学专家认为抑郁是一个重要的危险因素。我们想知道从现有数据中遗漏了什么。方法：利用Medline、Current Contents、以及HealthInfo数据库对抑郁症和抑郁症状与心脏疾病结局相关的文献进行系统综述。由于之前的审查，我们特别关注2001年至2003年的出版物。结果：我们确定了21篇病因学和43篇预后文献，这些文献具有前瞻性设计，使用公认的抑郁症测量方法，并包括客观结果测量。我们还确定了79篇评论文章。除了样本大小、样本特征和测量时间的问题外，我们还注意到抑郁症定义的异质性、相同数据集的频繁重复发表、结果测量的异质性、协变量选择的各种方法以及综述文章的优势，所有这些因素都不能帮助说服怀疑者。结论：尽管存在这些问题，但大多数前瞻性研究的数据都支持抑郁是心脏危险因素，这些前瞻性研究承认抑郁指数和客观结果衡量标准。
Objective: Major North American cardiology organizations do not currently list depression among the officially recognized Cardiac risk factors, yet many behavioral medicine specialists believe depression to be an important risk. We wondered what was missing from the available data. Methods: The Medline, Current Contents, and PsychInfo databases were used to perform a systematic review of the literature linking depression and depressive symptoms with cardiac disease outcomes. Because of previous reviews, we paid particular attention to publications from 2001 to 2003. Results: We identified 21 etiologic and 43 prognostic publications that had prospective designs, used recognized measures of depression, and included objective outcome measures. We also identified 79 review articles. In addition to issues of sample size, sample characteristics, and timing of measures, we noted heterogeneity in the definitions of depression, frequent repeat publications from the same data sets, heterogeneity of outcome measures, a variety of approaches for covariate selection, and a preponderance of review articles, all factors that cannot help to convince skeptics. Conclusions: Despite these issues, the bulk of the data from prospective studies with recognized indices of depression and objective outcome measures is supportive of depression as a cardiac risk factor.