Dr. Rick Levy from Washington, DC who will be delivering a lecture on improving patient outcomes by treating stress, depression and anxiety in the forthcoming Cardiological Society of India meet to be held at Hyderabad in early December said that depression, anxiety and ‘chronic worry’ correlate with a 2 to 5 times higher risk of developing heart blockages and 3 to 5 times higher morbidity and mortality patients with established blockages.
Screening and treating heart patients for depression and anxiety should be a standard practice. In the west over half of all heart patients suffer from depression or anxiety at some point, said Dr H K Chopra incoming President of National CSI.
A busy cardiologist can identify patients with clinical levels of depression and anxiety using an easy two-question Patient Health Questionnaire, or PHQ-2 – self-administered by the patient in less than a minute, and scored by a nurse or admitting staff member in less than 15 seconds.
The two questions to be asked are over the past two weeks how often have you been bothered by any of the following problems: Little interest or pleasure in doing things and Feeling down, depressed, or hopeless.
Give zero marks for not at all; 1 mark for several days, 2 marks for 50% of the days and 3 marks for every day. If the patient has a positive response to either question he or she needs a referral and treatment. Maximum marks can be 6 and a cut off of 3 points can be taken a point for referral and treatment.
Commenting on the study Padma Shri, Dr B C Roy National and National Science Communication Awardee Dr K K Aggarwal Senior National Vice President Indian Medical Association said that Psychotherapy and regular meditation have been clinically proven to improve health outcomes for heart patients with depression and anxiety.
SSRIs are the only antidepressant proven relatively safe for heart patients.