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Beach, Scott

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Beach, Scott

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    Depression and Cardiac Disease: Epidemiology, Mechanisms, and Diagnosis
    (Hindawi Publishing Corporation, 2013) Huffman, Jeffery; Celano, Christopher; Beach, Scott; Motiwala, Shweta; Januzzi, James
    In patients with cardiovascular disease (CVD), depression is common, persistent, and associated with worse health-related quality of life, recurrent cardiac events, and mortality. Both physiological and behavioral factors—including endothelial dysfunction, platelet abnormalities, inflammation, autonomic nervous system dysfunction, and reduced engagement in health-promoting activities—may link depression with adverse cardiac outcomes. Because of the potential impact of depression on quality of life and cardiac outcomes, the American Heart Association has recommended routine depression screening of all cardiac patients with the 2- and 9-item Patient Health Questionnaires. However, despite the availability of these easy-to-use screening tools and effective treatments, depression is underrecognized and undertreated in patients with CVD. In this paper, we review the literature on epidemiology, phenomenology, comorbid conditions, and risk factors for depression in cardiac disease. We outline the associations between depression and cardiac outcomes, as well as the mechanisms that may mediate these links. Finally, we discuss the evidence for and against routine depression screening in patients with CVD and make specific recommendations for when and how to assess for depression in this high-risk population.
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    (PO-176) Suicidal Ideation and Behavior During the COVID-19 Pandemic: A Retrospective, Single-Center Case Series
    (Elsevier BV, 2022-05) Sorg, Emily; Nisavic, Mladen; Beach, Scott; Maclean, Rachel; Kontos, Nicholas; Smith, Felicia
    Objective: In the few months since the first cases were reported, the coronavirus disease 2019 (COVID-19) has emerged as a global pandemic and significant source of morbidity and mortality. Case reports from early-hit countries raise concerns for potential worsening behavioral health outcomes, including suicidality, due to infection and/or related psychosocial and financial stressors. Our project offers an early examination of the impacts of the COVID-19 pandemic on suicidality for patients hospitalized at a tertiary hospital in a hard-hit urban area. Data Sources and Study Selection: We performed a retrospective chart review of all hospitalized adult patients who required psychiatric consultation during the first month of the COVID-19 outbreak (March 15, 2020 - April 15, 2020). Charts were reviewed for key demographic factors including COVID-19 infection status, premorbid/active behavioral health and substance use concerns, and presence of suicidality. Cases/Results: We present six cases, outlining important demographic, psychiatric, and psychosocial risk factors for suicidality in the setting of ongoing COVID-19 pandemic. We further contextualize the cases with additional data regarding all COVID-19 related consultations for suicidality during this period. Discussion: Our findings add to the growing literature on psychiatric implications of the COVID-19 pandemic and offer additional insights into potential risks factors for suicidality in vulnerable patient populations, as well as in patients with no premorbid psychiatric issues. Conclusion: To our knowledge, we present the first case series on suicidality coincident with the COVID-19 pandemic in a tertiary hospital setting. Further investigation of the topic is clearly warranted.