This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (17)  • Contact me when this article is cited  Related Content  • Similar articles in this journal

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

The review by McDermott et al¹ of studies linking adherence behavior to coronary heart disease outcomes is interesting and provocative. The authors review findings indicating that adherence to placebo is also related to reduced morbidity and mortality and therefore suggest that adherence behavior per se is important in coronary heart disease outcomes. While we agree with the possibility suggested by the authors that "adherence is a marker of some unidentified health care behavior that is itself linked to prognosis," we would like to also propose an alternative explanation that nonadherence is a marker of psychological factors that adversely affect outcome in patients with coronary heart disease, like depression and psychological distress.^2-3

We recently assessed 144 patients an average of 3 days after an acute myocardial infarction (MI) to determine the presence of symptoms of depression using the Beck Depression Inventory⁴ and then again at 4 months using the Medical Outcomes . . . [Full Text of this Article]

Corresponding author: Roy C. Ziegelstein, MD, Department of Medicine, Division of Cardiology, Johns Hopkins Bayview Medical Center, 4940 Eastern Ave, Baltimore, MD 21224-2780 (e-mail: rziegels@welchlink.welch.jhu.edu).

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Medication Adherence Following Coronary Artery Bypass Graft Surgery: Assessment of Beliefs and Attitudes
Khanderia et al.
The Annals of Pharmacotherapy 2008;42:192-199.
ABSTRACT | FULL TEXT  

Depression, the Metabolic Syndrome and Cardiovascular Risk
Vaccarino et al.
Psychosom. Med. 2008;70:40-48.
ABSTRACT | FULL TEXT  

Heart Rate Variability in Acute Coronary Syndrome Patients With Major Depression: Influence of Sertraline and Mood Improvement
Glassman et al.
Arch Gen Psychiatry 2007;64:1025-1031.
ABSTRACT | FULL TEXT  

Depression is associated with cardiac symptoms, mortality risk, and hospitalization among women with suspected coronary disease: the NHLBI-sponsored WISE study.
Rutledge et al.
Psychosom. Med. 2006;68:217-223.
ABSTRACT | FULL TEXT  

Relation between psychological strain and carotid atherosclerosis in a general population
Wolff et al.
Heart 2005;91:460-464.
ABSTRACT | FULL TEXT  

Cytokines in Depression and Heart Failure
Pasic et al.
Psychosom. Med. 2003;65:181-193.
ABSTRACT | FULL TEXT  

Psychosocial Variables Are Associated With Atherosclerosis Risk Factors Among Women With Chest Pain: The WISE Study
Rutledge et al.
Psychosom. Med. 2001;63:282-288.
ABSTRACT | FULL TEXT  

Depression and Anxiety As Predictors of Outcome After Myocardial Infarction
Mayou et al.
Psychosom. Med. 2000;62:212-219.
ABSTRACT | FULL TEXT  

Impact of Psychological Factors on the Pathogenesis of Cardiovascular Disease and Implications for Therapy
Rozanski et al.
Circulation 1999;99:2192-2217.
ABSTRACT | FULL TEXT