Depression Screening in Cardiac

more impressive, with several studies suggesting that the impact of depression on QOL exceeds that of car-diac symptoms, ejection fraction, and coronary artery anatomy.6,7 Whether effective treatment of depression can diminish cardiac mortality or morbidity remains a question for future research. However, there are numer-ous biological links between depression and heart dis-ease, some of which have been shown to be potentially reversible with appropriate treatment of depression.8-11 Although not definitive, existing data do suggest that the treatment of depression in patients with coronary disease is appropriate because depression (1) causes suffering in a variety of contexts; (2) negatively affects treatment compliance; and (3) is associated with adverse clinical events. Furthermore, numerous effec-tive treatments exist including a variety of empirically validated treatments and pharmacotherapy. Indeed, the selective serotonin reuptake inhibitors (SSRIs) class of antidepressants has been shown to be both effective and safe in post-AMI and unstable angina patients.12 Cognitive behavioral therapy has also been shown to improve clinical depression, alone or with the use o