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Survival after myocardial infarction worse with first episode major depression than recurrent major depression

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Is the association with cardiac mortality different between people with a first episode of major depression (MD) and recurrent MD?


1328 people post-myocardial infarction (MI) from the Enhancing Recovery in Coronary Heart Disease (ENRICHD) clinical trial. 370 participants were diagnosed with first episode of MD, 550 participants had recurrent MD and 408 people were free of depression. Exclusion criteria: cognitive impairment, other major psychiatric disorders, other life threatening medical illnesses, imminent risk of suicide, too ill to participate, taking antidepressants for less than 14 days (for participants with depression only) or exemption from their cardiologist.


Coronary care units at eight ENRICHD clinical trial sites, USA; recruitment October 1996–October 1999.

Prognostic factors:

Depression was diagnosed using the Depression Interview and Structured Hamilton which uses DSM-IV criteria to diagnose current depressive episodes and the Hamilton Rating Scale for Depression to determine depression severity. …

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  • Sources of funding National Heart, Lung and Blood Institute, National Institute of Health, Grant 2 RO-1HL58946 and the Lewis and Jean Sachs Charitable Lead Trust.


  • Competing interests: None.

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