Symptoms of depression and anxiety before and after myocardial infarction: The HUNT 2 and HUNT 3 study

Abstract

The long-term effect of having a myocardial infarction (MI) and to what extent post-MI anxiety and depression can be attributed to pre-MI anxiety and depression are not known. Anxiety as an independent risk factor for the onset of MI is not clear and studies treating anxiety and depression as continuous variables are lacking. Baseline data in this prospective study were obtained from the Health Study of Nord-Trøndelag County (HUNT 2). Anxiety and depression were measured with the Hospital Anxiety and Depression Scale (HADS) at HUNT 2. Age, gender, waist circumference, hypertension, total cholesterol, diabetes, and years of daily smoking were included as control variables. In the sample of 28,859 participants, 770 MI were reported in the follow-up study 5-8 years later (HUNT 3). The level of depressive symptoms at HUNT 2 was a significant and independent predictor of MI at HUNT 3, while symptoms of anxiety were not. Level of anxiety and depression at HUNT 3 was best predicted by baseline anxiety and depression. Having an MI had only a marginal effect on the levels of anxiety and depressive symptoms at HUNT 3. In the MI group, time since MI was not a significant predictor of anxiety and depression.

Death anxiety in patients with myocardial infarction or cancer

“…Our findings indicating higher levels of death anxiety in MI patients were consistent with previous studies 16, 17, 18, 19. While higher levels of anxiety predict for a heart attack according to literature, heart attack itself seems to be a predictor for higher levels of anxiety 20, 21.…”

“…This may be caused by facing death suddenly and unexpectedly. While studies on MI’s association with anxiety levels are mostly focused on anxiety as a predictor for cardiac event,13, 14, 15 a few studies focused on anxiety levels during or after the course of MI 16, 17. Studies focusing specifically on death anxiety or fear of death are fewer 18, 19…”

Protective Effect of Regular Physical Activity on Depression After Myocardial Infarction: The HUNT Study

“…Additionally, prospective results from the HUNT Study found that the level of depressive symptoms at HUNT2 was a significant and independent predictor of myocardial infarction at HUNT3; but having an myocardial infarction had only a marginal effect on depressive symptoms at HUNT3 and time since myocardial infarction was not a significant predictor of post myocardial infarction depression. 33 Thus, our finding that 11% of the total sample was depressed after myocardial in may not be related to the former experience of myocardial infarction.…”

Personality traits, gender differences and symptoms of anhedonia: What does the Hospital Anxiety and Depression Scale (HADS) measure in nonclinical settings?

“…Further, some argue that gender differences in personality are much larger than traditionally assumed, especially concerning neuroticism (Del Giudice, Booth & Irwing, ). In a recent study, the dimensions of HADS (Zigmond & Snaith, ) predicted substantial long‐term stability, even over a 5–8 year period (Langvik & Hjemdal, ), suggesting that HADS represents a dispositional tendency. While neuroticism is viewed as an efficient marker of nonspecified general risk for all types of mental disorders (Ormel, Jeronimus, Kotov et al ., ), the role of extroversion in predicting symptom‐level has shown more specific relevance for depression (Watson et al ., ).…”