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The Need for Research on Interventions

Redford B. Williams, MD; Margaret A. Chesney, PhD

JAMA. 1993;270(15):1860-1861.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

The report by Frasure-Smith et al¹ in the current issue of THE JOURNAL, showing a fivefold higher mortality rate among depressed myocardial infarction survivors, should signal, we believe, a turning point in how we think about the role of psychosocial factors in the prognosis of coronary heart disease (CHD). The new findings indicate that rather than conducting additional studies to document yet again the adverse effects of psychosocial factors on prognosis, it is now time to develop and evaluate interventions aimed at ameliorating the harmful effects of these risk factors.

A considerable body of evidence already clearly documents a strong adverse impact of social isolation on prognosis in CHD patients, independently of the severity of the underlying cardiac disease.^2-4 Several other studies, most using retrospective designs and self-report measures of depression, have also found increased cardiac event rates in CHD patients who are depressed. In their current report . . . [Full Text PDF of this Article]

Author Affiliations
From the Behavioral Medicine Research Center, Duke University Medical Center, Durham, NC (Dr Williams); and the Prevention Sciences Group, University of California, San Francisco (Dr Chesney).

Footnotes
Reprint requests to Box 3926, Duke University Medical Center, Durham, NC 27710 (Dr Williams).

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