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The Clinical Impact of Negative Psychological States: Expanding the Spectrum of Risk for Coronary Artery Disease

From the Department of Society, Human Development and Health, Harvard School of Public Health, Boston, Massachusetts (L.D.K.); the Division of General Medicine, Columbia College of Physicians & Surgeons, and the Cardiovascular Institute, Mount Sinai School of Medicine, New York, NY (K.W.D.); and the Division of Cardiology, St. Luke's–Roosevelt Hospital Center, and the Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY (A.R.).

View larger version (19K): [in a new window]   Figure 1. Postmyocardial infarction (MI) patients were recruited and assigned to 1 of 4 categories based on the Beck Depression Inventory (BDI), ranging from no depressive symptoms (BDI <5) to moderate to severe depressive symptoms (BDI 19). During the 5-year follow-up period, a gradient relationship was observed between the magnitude of depressive symptoms and the frequency of deaths, with increased events occurring even in patients with mild depressive symptoms (BDI of 5–9). Reprinted with permission from Lesperance et al (4).