Theories of depression and anxiety and cardiovascular outcomes in psychosomatic medicine and behavioral cardiology

Dr. Rutledge and colleagues (1) are to be commended for evaluating the joint effects of depression and anxiety symptoms in cardiac outcomes. Like-wise those responsible for adding de-pression and anxiety questionnaires to the National Heart, Lung and Blood Institute-Sponsored Women's Ischemia Syndrome Evaluation study protocol after enrollment had commenced are also commended. Diagnostic comorbidity, measurement overlap, and self-report measure interrelation (2) are plausible reasons to evaluate the concurrent prog-nostic value and joint or interaction effects of depression and anxiety with cardiovascular outcome.