According to the European Society of Cardiology, about 18 percent of patients who suffer a heart attack develop major depressive disorder in the year after the attack. Now, new research from Lithuania suggests that women are more vulnerable to depression as well as anxiety after a heart attack.
Depression is a major predictor of quality of life, overall disability and even survival following a heart attack. According to the Professor Pranas Serpytis, lead author of the new study, “patients with depression are nearly six times more likely to die within six months after an MI (myocardial infarction or heart attack) than those without depression.”
The research team led by Serpytis interviewed 160 patients who were admitted to Vilnius University Hospital Santariskiu Clinics following a heart attack. In addition to gathering information about each patient’s demographics, clinical characteristics, cardiovascular risk factors and mental health history, the interviewers evaluated each patient using the Hospital Anxiety and Depression Scale (HADS).
Average Depression and Anxiety Scores Higher for Women
A score of 0 to 7 on the HADS scale indicates no depression or anxiety, a score of 8 to 10 indicates possible depression or anxiety, and a score of 11 or higher indicates mild to moderate depression or anxiety. Nearly one-quarter of the patients in this study—24.4 percent—had mild to moderate symptoms of depression and anxiety.
Overall, the average HADS depression score for the male subjects in this study was 6.87, and the average HADS depression score for the female subjects was 8.66. The average score for anxiety among the men was 7.18, and the average score for anxiety among the women was 8.20.
Results Also Show Correlation Between Smoking and Anxiety
The researchers also discovered a strong correlation between smoking and higher levels of anxiety. Among the 15.6 percent of the study participants who were regular smokers, the average anxiety score was 10.16. Interestingly, the average anxiety score for patients who used to smoke but quit at least two years ago was lower (4.55) than the score for patients who had never smoked (7.3).
Depression More Likely Among Less Physically Active Patients
Physical activity was associated with lower depression scores among the patients in the study, and those who were not physically active had an average depression score of 8.96. Exercise is also associated with positive moods and lower stress among the general population, so this information is not necessarily surprising. However, among patients recovering from a heart attack, increasing physical activity could have an even greater positive effect on mood because patients will know that more exercise decreases their chances of a future heart attack.
Depression and Anxiety Often Untreated in Heart Attack Patients
Although depression and anxiety are serious risks for patients in recovery after a heart attack, the conditions often go unnoticed and untreated. This is largely because the life-threatening nature of a heart attack tends to overshadow problems that are not directly related to cardiac health.
However, because depression can have such a serious effect on both the quality of life and the chance of full recovery after a heart attack, it is critically important to screen patients for mental health problems during the first year after a heart attack. The data from this study suggests that female patients in particular should be carefully assessed for depression or anxiety. The results of this research also suggest that patients will decrease their risk of anxiety and depression if they get help to quit smoking and are encouraged to get more regular exercise.