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University of Iowa News Release

Feb. 15, 2006

Research Links Depression With Delay In Seeking Heart Attack Treatment

New research conducted by investigators in the University of Iowa College of Nursing has found that those suffering from depression may be more likely to delay seeking treatment for symptoms of heart attack than the study subjects who were not depressed.

The research, led by René Martin, Ph.D., assistant professor of nursing, in collaboration with James Bunde, a doctoral candidate in clinical psychology at the UI, is reported in the most recent issue of the journal Psychosomatic Medicine.

The purpose of the study was to evaluate how depression might influence treatment-seeking behaviors as symptoms of heart attack develop. The researchers asked 433 subjects to recall whether they had depressive symptoms in the weeks preceding their heart attack and interviewed them regarding their treatment-seeking behaviors.

Delay in seeking treatment for acute symptoms of heart attack, also known as myocardial infarction (MI), was observed among participants who reported being depressed during the two weeks before hospitalization. Findings also indicated that among depressive symptoms, sleep disturbance and fatigue contributed to the delay in seeking treatment.

According to the UI College of Nursing study, depression had no effect on perceived seriousness of symptoms or on the impact of symptoms on the ability to perform activities of daily living.

"In fact, depressed participants were more likely to recall that a family member or friend had advised them to seek medical intervention," Martin said. "It is particularly worrisome that depressed individuals delayed seeking treatment despite receiving sound advice from members of their support network."

Martin speculates that while those with depression delayed in seeking help, they likely were not engaging in "suicide by MI." Rather, the nursing researchers point out that those most likely to delay seeking treatment were subjects who experienced sleep disturbance and fatigue. They further suggest the association between depression and delay could be a consequence of difficulties in mobilizing the energy necessary to seek care.

"Depression warrants further attention as a variable that may influence treatment-seeking for heart attack symptoms," Martin said. "Our results highlight the need to adequately screen for and treat depression among persons at risk for congestive heart failure or subsequent heart attacks."

According to the National Institute of Mental Health, in any given one-year period, about 18.8 million American adults suffer from a depressive illness. Depression is particularly problematic in people with coronary heart disease, who suffer increased morbidity and mortality.

STORY SOURCE: University of Iowa College of Nursing, 101 Nursing Building, Iowa City, Iowa 52242

MEDIA CONTACT: Michele Francis, 319-335-8960,