A topographical map of the causal network of mechanisms underlying the relationship between major depressive disorder and coronary heart disease
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Objective: Major depressive disorder (MDD) and coronary heart disease (CHD) are both clinically important public health problems. Depression is linked with a higher incidence of ischaemic cardiac events and MDD is more prevalent in patients with CHD. No single comprehensive model has yet described the causal mechanisms linking MDD to CHD. Several key mechanisms have been put forward, comprising behavioural mechanisms, genetic mechanisms, dysregulation of immune mechanisms, coagulation abnormalities and vascular endothelial dysfunction, polyunsaturated omega-3 free fatty acid defi ciency, and autonomic mechanisms. It has been suggested that these mechanisms form a network, which links MDD and CHD. The aim of this review is to examine the causal mechanisms underlying the relationship between MDD and CHD, with the aim of constructing a topological map of the causal network which describes the relationship between MDD and CHD. Methods: The search term ' depression and heart disease ' was entered into an electronic multiple database search engine. Abstracts were screened for relevance and individually selected articles were collated. Results: This review introduces the fi rst topological map of the causal network which describes the relationship between MDD and CHD. Conclusions: Viewing the causal pathways as an interdependent network presents a new paradigm in this fi eld and provides fertile ground for further research. The causal network can be studied using the methodology of systems biology, which is briefl y introduced. Future research should focus on the creation of a more comprehensive topological map of the causal network and the quantifi cation of the activity between each node of the causal network.
Australian & New Zealand Journal of Psychiatry
Copyright 2011 Informa Healthcare. This is an electronic version of an article published in Australian and New Zealand Journal of Psychiatry Vol. 45(5), 2011, pp. 351-369. Australian and New Zealand Journal of Psychiatry is available online at: http://informahealthcare.com with the open URL of your article.
Cardiology (incl. Cardiovascular Diseases)
Health, Clinical and Counselling Psychology