Up to 20% of patients hospitalized for heart attack meet the criteria for major depression. Healthcare providers should routinely screen patients with heart disease for signs of depression, according to a new advisory issued by the American Heart Association (AHA) and published online September 29, 2008 online in the journal Circulation.

This AHA advisory, endorsed by the American Psychiatric Association, also recommends referring those heart disease patients with suspected depression to a mental health professional and monitoring or coordinating the management of any patient receiving treatment for both heart disease and depression. These guidelines represent the first time the AHA has published a document of recommendations specifically addressing the well-recognized link between cardiovascular disease and depression.

Although a direct link between screening for depression and improved outcomes in people with heart disease has not yet been established, there is plenty of evidence that treating depression in patients with cardiovascular problems can be beneficial. The authors of the advisory point out that the extra time required to administer initial depression screening is minimal, consisting of a two-item Patient Health Questionnaire (PHQ) followed by nine-item questionnaire for patients with possible depression. This small effort could potentially make a big difference.