This randomized controlled trial, with a 6-month follow-up, assessed the effectiveness of a consultation-liaison psychiatry (CLP) intervention. A group of 129 consecutive patients admitted to a ICU with myocardial infarction or unstable angina was assessed during the first 48 hours of admission with the Hospital Anxiety and Depression Scale (HADS). Those with a score ?8 on depression or anxiety (n=72) were randomly allocated to intervention (n=37) and usual care (n=35). The intervention included psychiatric evaluation, supportive psychotherapy, psychoeducation and psychotropic drugs. Anxiety and depression were reassessed before discharge, and at 45 days, 3 and 6 months. Other outcome variables were survival, number of readmissions and of sick leave days, and return to work. Data was analysed with Student's t-test and Chi-square. The intervention group had a significantly lower depression mean score at 6 months (5.8±4.1 vs. 7.9±4.3 in the control group, t=2.1, p=. 04), and a lower number of patients with a depression score ?8 at 3 (11 vs. 18 controls, chi-square=4.4, p=. 04), and 6 months (12 vs.18 controls, chi-square=3.9, p=. 05). The number of patients with an anxiety score ?8 was lower in the intervention group at 3 (15 vs. 23 controls, chi-square=6.6, p=. 01), but not at 6 months. The two groups did not differ in any of the other outcome variables. The results confirm the effectiveness of a CL intervention in the treatment of depression in acute coronary patients. The intervention had no impact on survival, coronary events, and return to work at 6 months