Roy C. Ziegelstein, MD, Department of Medicine, Division of Cardiology, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, MD.

Depressed mood is common after a myocardial infarction and is associated with increased mortality risk. Although mild forms of depression often resolve without specific treatment, moderate to severe depression is typically longer lasting. Depression is particularly unlikely to resolve spontaneously in those who are socially isolated, a common problem in older individuals. Patients may be screened for depression using one of several short and valid instruments. If antidepressant treatment is indicated, a selective serotonin reuptake inhibitor is preferred and should be combined with efforts to improve social support, to address medication adherence issues and to encourage participation in a cardiac rehabilitation program.
Key words: depression, myocardial infarction, screening, social support, antidepressants.