By counting on friends and family, heart attack survivors may be better able to fight depression during that critical first year following a heart attack, according to today's Circulation: Journal of the American Heart Association.
Depression is common among individuals recovering from a heart attack.
According to the study's lead author, Nancy Frasure-Smith, Ph.D., of the department of psychiatry at McGill University in Montreal and the Montreal Heart Institute, "The most striking finding was the association between strong social support and improvements in the symptoms of depression among these patients. This suggests that high levels of support may protect patients from the negative effects of depression and positively influence their prognosis."
Social support and depression have both been shown in other studies to influence survival from heart disease. However, this is the first study to examine the effects of these variables in combination after a heart attack, the researchers report.
Strong social support is defined as having a number of close friends, as well as having regular contact, either by phone or in person, with both friends and family members. People who are married or live with others are also more likely to have strong social support, says Frasure-Smith.
"It's important to remember that we're talking about how the patient perceives the support. Sometimes, even when the support is there, depressed people have a hard time seeing it, so providing that support can be a difficult job for family and friends," she says.
Researchers surveyed 887 individuals who had previously suffered a heart attack. Approximately a third of them were diagnosed with mild to moderate depression. During a one-year follow-up, 7.5 percent of the depressed patients died of cardiovascular diseases, compared to just 2.5 percent in the patients who were not depressed.
The study also underscores the prevalence of long-term depression in heart attack survivors, Frasure-Smith says. "Perhaps more worrisome than the mortality risk associated with depression is that about 50 percent of depressed heart attack patients are still depressed after one year."
Depression-fighting strategies include maintaining key social contacts enjoyed by patients prior to their heart attacks. "If the patient withdraws from these contacts, this can be an important danger signal," says Frasure-Smith.
For many patients, the study's findings indicate a need for professional intervention, such as counseling, beyond naturally occurring social support. Many heart attack patients experience some short-term depression, but if symptoms linger for more than three or four weeks, it's wise to seek medical attention," says Frasure-Smith.
Physicians should ask patients how they feel about the level of support from friends and family in order to assess the effects of post-heart attack depression, she says. "The answers to these questions could provide important clues to a patient's state of mind that could have a direct impact on his or her future survival."
"We know from previous research that depression is common following a heart attack, but it definitely isn't normal," says Frasure-Smith. "Our findings show that depressed patients are about three times more likely to die compared to heart patients who aren't depressed."
Co-authors were Francois Lesperance, M.D.; Ginette Gravel, M.S.c.; Aline Masson, M.S.c.; Martin Juneau, M.D.; Mario Talajic, M.D. and Martial G. Bourassa, M.D.
NR00-1134 (Circ/Frasure-Smith) Media advisory: Dr. Frasure-Smith may be reached by phone at 514-376-3330 ext. 3024. (Please do not publish number.)