This shows “that without comprehensive depression care and follow-up, very little seems to happen even after screening and assessment,” Dr. Ziegelstein said, adding that, given the differences in medication use between the groups, it was “somewhat disappointing” that the differences in depression response did not also persist after the 12-week intervention.
Thomas Rutledge, Ph.D., of the department of psychiatry the University of California, San Diego, lauded the low-cost and low-intensity nature of the trial intervention but cautioned that as the mental health benefits appeared to drop after 12 weeks, continued effectiveness might require longer term treatment protocols, “or phasing patients into some sort of aftercare maintenance treatment.”
Dr. Rutledge also pointed to the study’s use of PHQ screening to help identify subjects as important, and potentially hard to replicate. “Screening for depression in cardiac populations is recommended by the American Heart Association but is often impractical without staff and care managers such as this study employed to accomplish this task,” he said. “Any effort to implement this study protocol in clinic would require that staff be identified for the administration and scoring of depression screening instruments.”
Dr. Huffman’s study was funded by the American Heart Association. Neither he nor his colleagues declared conflicts of interest.
* UPDATE, 3/9/2011: This article has been edited to reflect updated comments from Dr. Rollman and Dr. Ziegelstein.