Symptom dimensions of post-myocardial infarction depression, disease severity and cardiac prognosis

Martens, Elisabeth J.; Hoen, Petra W.; Mittelhaeuser, M.; Jonge, de Peter; Denollet, Johan

doi:10.1017/s0033291709990997

Cited by 98 publications

(92 citation statements)

References 33 publications

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“…There is also the possibility that the effect of anhedonia are accounted for by their association with somatic symptoms, which were not assessed in the present study. While this was not shown to be the case in another study (9), a mixture of dissatisfaction/anhedonia has tended to load on a somatic factor in other research (4,24). In conclusion, the HADS-D scale seems to assess symptoms which are important for predicting cardiovascular prognosis, despite these symptoms being highly correlated with other symptoms of anxiety.…”

Section: Discussionmentioning

confidence: 63%

Differential Predictive Value of Depressive Versus Anxiety Symptoms in the Prediction of 8-Year Mortality After Acute Coronary Syndrome

Doyle

Conroy

McGee

2012

Psychosomatic Medicine

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Differential predictive value of depressive versus anxiety symptoms in the prediction of 8-year mortality following acute coronary syndrome AbstractObjective: Both depression and anxiety and been associated with poor prognosis in patients with acute coronary syndrome (ACS). However, certain symptoms, and how they are measured, may be more important than others. We investigated 3 different scales to determine their predictive validity in a national sample.

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Section: Discussionmentioning

confidence: 63%

Differential Predictive Value of Depressive Versus Anxiety Symptoms in the Prediction of 8-Year Mortality After Acute Coronary Syndrome

Doyle

Conroy

McGee

2012

Psychosomatic Medicine

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“…The extent to which the association between somatic depressive symptoms and adverse cardiac outcomes can be attributed to somatic complaints related to cardiac disease severity has been the object of debate [De Jonge et al 2006;Martens et al 2010b;Roest et al 2011]. …”

Section: Introductionmentioning

confidence: 99%

Symptom dimensions of anxiety following myocardial infarction: Associations with depressive symptoms and prognosis.

et al. 2014

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ObjectiveDifferential associations of symptom dimensions with prognosis in myocardial infarction (MI) patients have been shown for depression, but no studies have focused on anxiety dimensions.The aim of this study was to assess the association between somatic and psychological symptoms of anxiety following acute MI with adverse prognosis and to assess the overlap between anxiety and depression dimensions. MethodsPatients (n=418) were assessed on demographic and clinical variables. The Hamilton Anxiety and Depression Rating Scales were used to measure anxiety and depression 2 months post-MI.Mean follow-up period was 3.8 years and the endpoint consisted of all-cause mortality and recurrent MI. ResultsAfter adjustment for demographic and clinical variables, somatic anxiety was significantly associated with recurrent MI and mortality (HR: 1.32; 95% CI: 1.03-1.69; p=0.03), while a trend was shown for an association between psychological anxiety and outcome (HR: 1.29; 95% CI: 0.99-1.67; p=0.06). The total anxiety score of the HARS was the strongest predictor of recurrent MI and mortality (HR: 1.38; 95% CI: 1.07-1.78; p=0.02). The HARS and the HDRS were highly correlated (r=0.86; p<0.01). Dimensions consisting of psychological distress (HR: 1.29; 95% CI:1.02-1.63; p=0.03) and cardiopulmonary/autonomic symptoms (HR: 1.36; 95% CI: 1.06-1.75; p=0.02) also predicted outcome in adjusted analyses. ConclusionsAnxiety was associated with adverse prognosis in MI patients with significant associations for somatic anxiety and total anxiety. When combining anxiety and depression items, psychological distress and cardiopulmonary/autonomic symptoms predicted recurrent MI and mortality. Future 4 research might better focus on dimensions of anxiety and depression simultaneously in MI patients.

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“…Therefore, it cannot be ruled out that the differential risk of worse outcome between subgroups found by some of the studies is caused by subgroup imbalances in some measured or unmeasured patient characteristics, such as a severer underlying coronary artery disease [38,39] or a deteriorating health status. This may also underlie the increased risk of worse prognosis that is found for cardiac patients with somatic rather than cognitive symptoms of depression [3,40,41] , and ACS patients with persisting or increasing depressive symptoms and treatment-resistant depression [5,6,23,42,43] . MI patients with persisting depressive symptoms report worse physical health 12 months after the MI [44] , supporting that a deteriorating health status may indeed underlie the association with worse prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…It is possible that relationships between these subtypes of post-ACS depression and cardiac outcomes reported by some studies [8,9,21,22] reflect 6 1 underlying risk factors, such as coronary artery disease severity at baseline, a deteriorating health status or 'vascular depression'. These underlying risk factors may also cause the increased risk for patients with persistent and treatment-resistant depression and somatic symptoms of depression found in other studies [3,5,6,23,[40][41][42] . Identifying high-risk subgroups of depressed ACS patients and possibly underlying risk factors is important for understanding the overall relationship between depression and cardiac prognosis and may potentially lead to the development of more individually targeted interventions.…”

Section: Discussionmentioning

confidence: 99%

Onset and Recurrence of Depression as Predictors of Cardiovascular Prognosis in Depressed Acute Coronary Syndrome Patients: A Systematic Review

Zuidersma

Thombs

Jonge

2011

Psychother Psychosom

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Background: Depression after acute coronary syndrome (ACS) is associated with worse cardiac outcomes. This systematic review evaluated whether depressed ACS patients are at differential risk depending on the recurrence and timing of onset of depressive episodes. Methods: MEDLINE, EMBASE and PsycINFO were searched from inception to 11 April 2009. Additionally, reference lists and recent tables of contents of 34 selected journals were manually searched. Eligible studies evaluated cardiovascular outcomes for subgroups of ACS patients with depression or depressive symptoms according to recurrence or onset. Results: Six studies were included that reported outcomes for subgroups of ACS patients with first-ever versus recurrent depression. Four of these reported also outcomes for post-ACS onset versus pre-ACS onset depression, and incident versus nonincident depression. Worse outcomes (odds ratio >1.4) were reported for ACS patients with first-ever depression in 3 of 6 studies (1 study p < 0.05), for patients with post-ACS onset depression in 3 of 4 studies (1 study p < 0.05, but better outcomes in one study) and for patients with incident depression in 2 of 4 studies (no studies p < 0.05). Conclusions: Although it is still suggested that ACS patients with first and new-onset depression are at particularly increased risk of worse prognosis, the inconsistent results from the studies included in this systematic review show that there is no consistent evidence to support such statements.

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Symptom dimensions of post-myocardial infarction depression, disease severity and cardiac prognosis

Abstract: We confirmed that somatic/affective, rather than cognitive/affective, symptoms of depression are associated with MI severity and cardiovascular prognosis. Interventions to improve cardiovascular prognosis by treating depression should be targeted at somatic aspects of depression.

Cited by 98 publications

References 33 publications

Differential Predictive Value of Depressive Versus Anxiety Symptoms in the Prediction of 8-Year Mortality After Acute Coronary Syndrome

Differential Predictive Value of Depressive Versus Anxiety Symptoms in the Prediction of 8-Year Mortality After Acute Coronary Syndrome

Symptom dimensions of anxiety following myocardial infarction: Associations with depressive symptoms and prognosis.

Onset and Recurrence of Depression as Predictors of Cardiovascular Prognosis in Depressed Acute Coronary Syndrome Patients: A Systematic Review

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