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Definitions and Distinctions Among Depressive Syndromes and Symptoms: Implications for a Better Understanding of the Depression–Cardiovascular Disease Association

From the Columbia College of Physicians and Surgeons, New York, NY (K.W.D.); the Cardiovascular Institute, Mount Sinai School of Medicine, New York, NY (K.W.D.); and the Department of Psychiatry, Mount Sinai School of Medicine, New York, NY (N.R., M.A.R.).

Address correspondence and reprint requests to Karina W. Davidson, PhD, Medicine, Columbia University College of Physicians and Surgeons, 622 W. 168th St., PH9 Center, Room 948, New York, NY 10032. E-mail: kd2124{at}columbia.edu

Objective: A prognostic role for depressive disorder presence and/or elevated depressive symptoms in the onset and recurrence of cardiovascular disease has been largely supported. Depression is a multifaceted disorder, encompassing a wide range of somatic, cognitive, and mood symptoms; it varies in intensity, duration, frequency, course, and family history; it can be assessed continuously or categorically; it can be obtained by interview or by self-report; and importantly, the cardiac prognostic impact of these distinctions may vary. We provide an overview of definitions and possible assessment of depression, and we discuss key assessment distinctions.

Conclusion: Examining the predictive ability of these key distinctions of depression for acute coronary syndrome recurrence would be of benefit to future research in this field.

Key Words: depression • cardiovascular disease • assessment • behavioral medicine

Abbreviations: CVD = cardiovascular disease; ACS = acute coronary syndrome; MDD = major depressive disorder; SCID = Structured Clinical Interview for DSM-IV; DIS = Diagnostic Interview Schedule; DISH = Depression Interview and Structured Hamilton.

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