Review: Depression, social isolation, and certain life events are associated with the development of coronary heart disease: COMMENTARY

Linden, Wolfgang
November 2003
ACP Journal Club;Nov/Dec2003, Vol. 139 Issue 3, p81
Academic Journal
Consensus committees are a critical element in the chain of basic research leading to improved clinical practice. The review by researchers S.J. Bunker and colleagues is well researched and written and provides clear conclusions. Although stress is widely understood, it is a fuzzy concept, and the authors focus on better-defined psychological constructs that represent emotional distress. However, they do not discriminate between individual characteristics and objective environmental features. This distinction is critical because environmental stimuli are often impossible to change. The authors have reviewed previously published review articles. Comprehensiveness can result from this strategy, but there also is a cost, if the most recent review was published in 2001, it means that the past 4 to 5 years of published research were not considered in this 2003 article because of cumulative publication lag. On the whole, it is not a major problem for trustworthiness of the conclusions given the known consistency in research linking depression and social isolation to CHD. Importantly, the most salient distress variables have a risk ratio similar in size to biological risk factors with a 3-to 4-fold relative risk.


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