Atlanta, GA - Young women are particularly susceptible to depression following acute myocardial infarction, a new study shows [1].

Of females under 60, 40% had at least moderate depression, Dr Susmita Mallik (Emory University School of Medicine, Atlanta, GA) and colleagues report in their paper in the April 24, 2006 issue of the Archives of Internal Medicine.

"For the first time, we found that younger women have a remarkably higher rate of depression at the time of AMI compared with the other demographic groups," they state. And because depression has been associated with adverse outcomes after MI, younger women may benefit most from aggressive screening and treatment of depression, they point out.

Mallik and colleagues assessed depression at the time of hospitalization in 2498 AMI patients (814 women and 1684 men) enrolled from 19 US centers in the Prospective Registry Evaluating Outcomes after Myocardial Infarction: Events and Recovery (PREMIER) study between January 2003 and June 2004.

Depression was defined as a Primary Care Evaluation of Mental Disorders Brief Patient Health Questionnaire (PHQ) score of 10 or higher.

The prevalence of depression was 40% in women 60 years or younger, 21% in females older than 60, 22% in men 60 or less, and 15% in men over 60.

After multivariable adjustment, women who were younger than 60 had a significant, three-times-higher risk of depression (odds ratio 3.1) compared with the reference group (men older than 60).

"Clinicians should be aware that younger women have a higher susceptibility for being depressed after AMI," say Mallik et al. "In addition to being an important illness in its own right . . . [it] confers three- to five-times-higher adjusted odds of death by six months after AMI . . . and its prognostic role is at least equivalent to . . . left ventricular dysfunction and a history of AMI."

Also, depression is associated with longer hospital stays and predicts worse symptomatic, psychological, and social outcomes at three and 12 months, they note.

Although hormonal influences and societal pressures may contribute to the increased risk observed, the reasons that younger women have this higher risk of depression after MI are essentially unknown and require further study, Mallik and colleagues conclude.