Factors associated with acute depressive symptoms in patients with comorbid depression attending cardiac rehabilitation

Sever, Serdar; Golder, Su; Doherty, Patrick

doi:10.1186/s12872-018-0974-2

Cited by 12 publications

(7 citation statements)

References 49 publications

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“…One possible explanation could be a need of more social support when living with a chronic disease, i.e. CD [38], but also that there is a higher likelihood of becoming depressed when having no partner [39], which in turn is related to poorer HRQoL.…”

Section: Discussionmentioning

confidence: 99%

The associations between psychological distress and health-related quality of life in patients with non-cardiac chest pain

Mourad

Alwin

Jaarsma

et al. 2020

Health Qual Life Outcomes

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Background: Recurrent chest pain episodes with no clear explanation may affect patients' psychological wellbeing and health-related quality of life (HRQoL) negatively. Despite the fact that a significant amount of patients with non-cardiac chest pain (NCCP) might have a history of Cardiac Disease (CD), there is today a lack of knowledge on how CD influences the association between psychological wellbeing and HRQoL in patients with NCCP. Therefore, the aim of this study is to describe HRQoL in patients with NCCP, with or without history of CD, and to explore the association between HRQoL and cardiac anxiety, depressive symptoms, fear of body sensations and somatization. Methods: Five hundred fifty-two patients discharged with NCCP from four hospitals in Southeast Sweden completed the EQ-5D, Cardiac Anxiety Questionnaire, Patient Health Questionnaire-9, Body Sensations Questionnaire, and Patient Health Questionnaire-15. Results: Fifty precent reported at least moderate problems regarding pain/discomfort and 25% reported at least moderate problems in the HRQoL dimensions mobility, usual activities, and anxiety/depression. Patients with NCCP and history of CD reported significantly lower HRQoL (p ≤ 0.05) compared to patients with NCCP without CD. In the total study population, cardiac anxiety, depressive symptoms, and somatization had weak significant negative associations (beta = 0.187-0.284, p < 0.001) with HRQoL. In patients with history of CD, the association between depressive symptoms and HRQoL was moderate (beta = − 0.339, p < 0.001), compared to weak association in patients without CD (beta = − 0.193, p < 0.001). On the other hand, the association between cardiac anxiety and HRQoL was weak in both patients with history of CD (beta = − 0.156, p = 0.05), and in those without (beta = − 0.229, p < 0.001). Conclusions: Patients with NCCP, in particular those with history of CD, reported low levels of HRQoL, which was associated with psychological distress. This should be considered when developing psychological interventions aiming to improve HRQoL in patients with NCCP.

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Section: Discussionmentioning

confidence: 99%

The associations between psychological distress and health-related quality of life in patients with non-cardiac chest pain

Mourad

Alwin

Jaarsma

et al. 2020

Health Qual Life Outcomes

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“…HADS anxiety scores of the patients with absence and presence of new onset depressive symptoms were also compared. The HADS and other measurements were explained in detail elsewhere [18].…”

Section: Methodsmentioning

confidence: 99%

“…Preliminary baseline assessments and the literature search were decisive for the inclusion of these variables. These variables have been explained in detail in a previous publication [18].…”

Section: Methodsmentioning

confidence: 99%

“…Some studies have shown that patients with history of depression prior to a heart event had increased cardiac morbidity and risk for mortality [14, 15], however, other research has shown that new onset depressive symptoms after a heart event was particularly related to increased mortality and adverse cardiac events [16, 17]. A recent paper using NACR data further developed this literature and found that patients with prior history of depression and who present with high level of depressive symptoms at the start of CR tend to have increased weight, BMI, anxiety symptoms, smoking, physical inactivity, and they were younger and more likely to be single compared to patients who have depression history but absence of depressive symptoms at the start of CR [18]. This study aims to build on the previous work done in this field with a unique population yet to be addressed, patients without history of depression, meaning patients with new onset post heart event depressive symptoms, to examine which patient characteristics are associated with developing new onset depressive symptoms in relation to cardiovascular disease.…”

Section: Introductionmentioning

confidence: 99%

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To what extent is multi-morbidity associated with new onset depression in patients attending cardiac rehabilitation?

Sever

Doherty

Harrison

et al. 2019

BMC Cardiovasc Disord

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BackgroundDepression is associated with increased mortality and poor prognosis in patients with cardiovascular disease (CVD). However, little is known about the patient characteristics associated with new onset post heart event depressive symptoms, specifically medical comorbidities, among cardiac rehabilitation (CR) participants. Therefore, this paper examines the comorbidity profile and characteristics associated with new onset depressive symptoms in patients attending CR.MethodsAn observational study using the routine practice data of British Heart Foundation National Audit of Cardiac Rehabilitation (NACR) from the last six years between April 2012 and March 2018. Patients with new onset post heart event depression and no previous documented history of depression were selected as the study population. An independent samples t-test and chi square tests were used to compare the association between new onset depressive symptoms and patient variables including demographics, clinical measures and comorbidities. A binary logistic regression was conducted to investigate the predictors of new onset depressive symptoms employing log-likelihood ratio statistic.ResultsThe analyses included 109,055 CR patients with new onset depression measured by Hospital Anxiety and Depression Scale (HADS). At baseline assessment, comorbidity measures associated with new onset depressive symptoms were increased total number of comorbidities and a range of comorbidities - including diabetes, angina, arthritis, chronic back problems, asthma, stroke, anxiety, rheumatism, claudication, osteoporosis, chronic bronchitis and emphysema. After multivariate adjustments were done, at the start of CR, the significant predictors of new onset depressive symptoms were physical inactivity, high HADS anxiety score measurement, increased weight, total number of comorbidities, diabetes, stroke, chronic back problems, being from areas with higher levels of social deprivation, being single, and male.ConclusionThe research findings establish new insights into the association between patient demographic and clinical variables across a range of comorbidities in patients with new onset post heart event depressive symptoms. At the start of CR, patients with new onset depressive symptoms need to be assessed skilfully as they tend to have a complex multi-morbid presentation linked to psychosocial risk factors known to hinder CR engagement.

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“…Incidence of anxiety and depression after ACS is as high as 50% [26][27][28], which might underlie poor adherence to and enrollment in CR, and consequently less physical activity, in patients after PCI [29,30]. Therefore, education of CR at our center includes psychological intervention.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of CPET Combined with Systematic Education of Cardiac Rehabilitation After PCI: A Real-World Evaluation in ACS Patients

Zhang

et al. 2021

Adv Ther

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Introduction: There are scarce real-world data on the long-term efficacy and safety of cardiopulmonary exercise testing (CPET) combined with the systematic education of cardiac rehabilitation (CR) approach for patients postcoronary stenting, which is, therefore, the subject of this study. Methods: Data collected between 1 April 2015 and 20 May 2017 from 11,345 patients in the rehabilitation center database at our hospital were retrospectively analyzed. Five hundred thirty-six patients with incomplete information, or unable to cooperate with telephone follow-up, were excluded; 4001 patients received the combined CR approach; and 6808 patients received only routine post-procedure education (controls). Of these, 2805 CR participants (CR group) were matched 1:1 to controls (control group) using propensity scores. The main outcome was quality of life in Seattle Angina Questionnaire (SAQ) scores. SAQ was measured in hospital and at follow-up; meanwhile, volume/type of habitual exercise, major adverse cardiovascular event (MACE), and its components of target vessel revascularization, myocardial infarction, and cardiac death were recorded and analyzed. Results: At median 583 (range 184-963) day follow-up, compared with controls, the CR group showed fewer patients not engaging in physical exercise (22 vs. 956, p \ 0.05); more cumulative exercise time (h/week) (8.22

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Factors associated with acute depressive symptoms in patients with comorbid depression attending cardiac rehabilitation

Cited by 12 publications

References 49 publications

The associations between psychological distress and health-related quality of life in patients with non-cardiac chest pain

The associations between psychological distress and health-related quality of life in patients with non-cardiac chest pain

To what extent is multi-morbidity associated with new onset depression in patients attending cardiac rehabilitation?

Efficacy of CPET Combined with Systematic Education of Cardiac Rehabilitation After PCI: A Real-World Evaluation in ACS Patients

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