This review examines the relationship between depression
in coronary heart disease (CHD). It summarizes relevant findings from general population and smoking cessation
studies and discusses the few studies that have investigated whether smoking
confounds, mediates, or moderates the effect of depression
on cardiac morbidity and mortality.
Qualitative review of research literature.
Although many studies of the prognostic importance of depression
in CHD have adjusted for smoking
, there is no convincing evidence that smoking
actually confounds the relationship between depression
and CHD. There is also no evidence that smoking
moderates this relationship. There is, however, limited evidence that smoking
may partially mediate the effect of depression
on morbidity and mortality in CHD.
We need more research on the relationship between depression
in CHD to develop a more complete model of the mechanisms linking depression
to cardiac morbidity and mortality.
CHD = coronary heart disease; MI = myocardial infarction.