Evid Based Nurs 2:129 doi:10.1136/ebn.2.4.129
  • Causation

Review: depression is associated with an increased risk of cardiovascular mortality and suicide

 Question Is depression associated with increased mortality and suicide?

Data sources

English language studies were identified by searching Medline, PsycINFO, and Health databases (from their inception to 1996) using the terms depression and affective disorders combined with mortality and death. Informal searches were also done.

Study selection

Inclusion criteria were assessment of the contribution of depression to the risk of death; depressive symptoms or depressive disorders assessed using clinical diagnosis, structured interview, or a standard symptom inventory; and mortality rates compared for the depressed sample and a comparison group. Studies of bereavement or single symptoms of depression were excluded.

Data extraction

Data were extracted on study quality and characteristics including sample size, measure of depression, choice of comparison group, factors controlled for in the analyses, mortality and suicide rates, and strength of evidence.

Main results

57 studies met the inclusion criteria. 29 studies (51%) reported that depression was associated with increased mortality, 13 (23%) did not find an association, and 15 (26%) had mixed results (eg, increased …

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