CincinnatióThe first systematic review of studies on depression and
early death shows that depression may increase the risk of death by
cardiovascular disease, especially in men. Researchers caution,
however, that methodological problems cause the 57 studies as a whole
to not support any broad conclusions about the relationship between
depression and early death. The review was published in the January 29
edition of Psychosomatic Medicine.
"Depression clearly increases the risk of death in some people under
some circumstances," says Lawson Wulsin, MD, associate professor of
psychiatry at the University of Cincinnati (UC) College of Medicine and
lead author of the review. "But we donít know much about who those
high-risk people are. Of the 57 studies from the last 30 years that
were reviewed, half reported that depression caused an increased risk
of death and the other half reported either no increased risk or mixed
findings. Only a third of the studies were methodically acceptable, and
only a few were well controlled."
The authors discovered that
while the male depressed population experienced an increased risk of
death by cardiovascular disease, depression did not affect the risk of
death by cancer. Suicide accounted for 15-19 percent of deaths in
depressed individuals, leaving the remaining early deaths of depressed
patients unexplained in most studies.
"The review shows that we
still don't know enough about depression and early death to prevent the
effect," says Wulsin. "We need more controlled studies to determine
what depressed patient populations are at risk of early death and how
depression increases the risk. For example, is the increased risk of
early death from cardiovascular disease a direct physiologic effect or
an indirect effect of poor self care?"
The other authors of the
study are Victoria Wells, MD, DrPH, Institute for Health Policy and
Health Services Research, University of Cincinnati Medical Center; and
George Vaillant, MD, Brigham and Womenís Hospital, Harvard Medical