Ischemic Heart Disease as an Important Risk Factor for Depression—A Case Report

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Considering the research objective, the article presents several limitations that compromise its quality:

 

1. The study is based on a single case, which limits the generalization of the results to a broader population. A larger and more diversified sample would be necessary to provide representative results required in a work of this nature.

2. As it is a case study, there is no control group for comparison. This complicates the evaluation of the treatment's effectiveness and the obtained results.

3. It is not clear how the patient was selected for the study or if there were specific inclusion and exclusion criteria. This could introduce bias in the interpretation of the results.

4. The article does not provide details about the methodology used in the patient's evaluation, such as psychological assessment tools or specific diagnostic criteria. This makes it difficult to assess the validity of the results presented.

5. The study mainly focuses on qualitative descriptions of symptoms and treatment, without providing quantitative data on treatment effectiveness or symptom evolution over time.

Finally, there is a lack of critical approach to the association between the conditions. Although the article highlights the association between ischemic heart disease and depression, it does not offer a critical analysis of the underlying mechanisms of this relationship, nor does it discuss possible confounding variables that could influence the results.

Author Response

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Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

The current case report investigates the link between heart disease and depressive symptoms. The researchers concluded that people with heart disease have a higher risk of developing depression, but patients with depression also have a higher risk of developing ischemic heart disease.

Indeed, the link between heart disease and psychiatric symptoms is highly interesting and yet underexplored. According to my point of view, this study introduces a significant topic. However, I have some doubts as regards the limited data derived from one patient and how strong they are to establish the main hypothesis. However, the researchers could conduct further research with large-scale experiments to further explain such a hypothesis.

The title clearly indicates the topic of the study.

The abstract is a short and clear summary of the aims. The methods could be more clearly explained as well as the results to support the main conclusion about the link between heart disease and depressive symptoms.

The introduction clearly summarizes the current state of the topic and addresses the limitations of current knowledge in this field. It would be useful to highlight the research questions and briefly describe in the last paragraph of the introduction the structure of the current study.

Methodology-results section provides information about the participant’s history and profile, and the diagnostic tools used to have a clearer understanding of the link between heart disease and depressive symptoms. The intervention section is adequately described.

According to my point of view, a discussion section would be useful to mention the strengths and limitations of the current case report, discuss and compare results with relevant studies in the field, to provide possible interpretations according to the selected data. Is any information available about the patient’s perspective?

 

 

Author Response

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Reviewer 3 Report

Comments and Suggestions for Authors

Thank you for the opportunity to review this paper.

Please kindly consider the following points and revise them: 

- As the authors could tell from one case report in the abstract: „In conclusion people with ischemic heart disease have a higher risk of developing depression, but patients with depression also have a higher risk of developing ischemic heart disease.” ?

- The introduction does not clearly state the significance or implications of the research, leaving the reader with limited information on why this study is important or how it contributes to the existing knowledge in the field. Additionally, the problem statement could be more clearly articulated.

- The authors did not provide a clear purpose of the research.

- There is not enough information about the patient in the material subsection.

- The method subsection does not describe the research protocols used.

- Biography-related patient history of illness data: There is no information in the medical history about previous psychiatric or psychological consultations. How do we know that the patient did not have any disorders before the coronary event, which could actually have exacerbated these symptoms? All the more so because the patient has a disabled son under her care, which in itself is a factor in the development of depression.

- The attached figures could be of better quality.

- No limitations of the study.

Author Response

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Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

The changes introduced by the authors address two fundamental weaknesses:

- The authors acknowledge the need for caution when considering the representativeness of an individual case, especially in scientific studies. They recognize that studies with larger and more diverse samples are generally preferable to ensure more generalizable and robust results. They have also pointed out the limitation and emphasized the necessity for additional studies to confirm and expand upon their findings.

- In addressing the lack of a control group, the authors responded by including a discussion section that contextualizes the results within the existing body of research on the association between depression and ischemic heart disease. This demonstrates a solid approach to compensating for the study's limitations.

 

However, the authors should reorganize the manuscript so that the conclusion appears after the discussion of the data.

Author Response

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Reviewer 2 Report

Comments and Suggestions for Authors

The authors significantly improved their manuscript according to the suggestions. The methodology section was improved in terms of the information provided. The presentation could be improved. The use of a table for the inclusion-exclusion criteria could improve the presentation. A final check in language (i.e., 2.2 heading) is required. Discussion could be placed before conclusions. It would be useful to improve the clarity of the figures.

Comments on the Quality of English Language

A final check in language is required.

Author Response

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Reviewer 3 Report

Comments and Suggestions for Authors

The corrections made by the authors satisfy the reviewer

Author Response

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Author Response File: Author Response.pdf