Increasing evidence of the critical importance of mental to physical health extends to those who have suffered cardiac emergencies.

In a new study, researchers at Tel Aviv University suggest mental health intervention should accompany lifestyle modification training for cardiac victims. Investigators found heart attack patients who also suffer from depression were more likely to be readmitted for cardiac events and chest pains, and have 14 percent more days of hospitalization than their happier counterparts.

Researcher Vicki Myers and colleagues examined the association between depressive symptoms in heart attack patients and hospital admissions more than a decade after the initial attack.

Myers said the discovery of increased utilization i.e. hospitalizations, place a massive financial burden on health services. This discovery suggests an investment in extra psychiatric support to mitigate depression may have a large positive payoff.

Most studies examining the connection between heart attack recovery and mental health have only included short-term followup, Myers said.

To study the effect of depression on the long-term health of heart attack patients, investigators used data collected from 632 heart attack patients under the age of 65 admitted to Israeli hospitals between 1992 and 1993, comparing their recoveries using followup data through 2005.

Investigators found that people identified as at least “mildly depressed” during their first hospital stay were far more likely to be re-hospitalized later with further cardiac health problems.

Further, individuals with a higher depression score spent 14 percent more time in the hospital than those with a low score. The findings are robust as researchers statistically controlled for measures of comorbidity, including other illnesses and risk factors such as smoking and socioeconomic status.

Post-heart-attack lifestyle choices played a major role in this relationship, said Myers. Most heart attack patients are offered rehabilitation services, and are advised to change their lifestyle to include exercise, diet, and smoking cessation programs.

Depressed patients are far less likely to avail themselves of rehab services, or elect to make life changes themselves, she said.

Overall, depressed patients were 20 percent less likely to be physically active after suffering a heart attack, 26 percent less likely to participate in a cardiac rehabilitation program, and 25 percent less likely to quit smoking.

“The message is that doctors cannot ignore psychological factors in patients who have had a heart attack. Patients who exhibit signs of depression need to be followed more closely, and may need extra help in following lifestyle recommendations. Ignoring this problem weighs heavily on health services,” she said.

Source: Tel Aviv University