Document Type

Article

Publication Date

2010

Keywords

Depression, Acute coronary syndrome, Mokken scaling, Item response theory, Prognosis, Myocardial infarction

Comments

This article is also available at http://www.jpsychores.com/ or http://www.sciencedirect.com/science/journal/00223999

Abstract

Objective To determine which particular depressive symptom scales, derived from three scales, predicted poorer prognosis in persons with acute coronary syndrome (ACS). Methods Hospitalised ACS patients (n=408) completed questionnaires (depression, vital exhaustion). Mokken scaling derived unidimensional scales. Major cardiac events (cardiac mortality, ACS, unplanned revascularisation) were assessed at median 67 weeks post-event. Results Only depressive symptoms of fatigue-sadness predicted prognosis in univariate (hazard ratio [HR]=1.8, 95% CI 1.1–3.0, p=0.025) and multivariate analysis (HR=1.8, 95% CI 1.1–2.9, p=0.025). Symptoms of anhedonia (HR=1.6, 95% CI 0.9–2.8, p=0.102) and depressive cognitions (HR=1.3, 95% CI 0.7–2.2, p=0.402) did not. Conclusion Symptoms of fatigue-sadness, but not other symptoms, were associated with increased risk of major cardiac events. Depression should be considered as a multidimensional, rather than a unidimensional, entity when designing interventions.

Disciplines

Psychology

Citation

Doyle F, Conroy R, McGee H, Delaney M. Depressive symptoms in persons with acute coronary syndrome: specific symptom scales and prognosis. Journal of Psychosomatic Research 2010 Feb;68(2):121-30.

PubMed ID

20105694

DOI Link

10.1016/j.jpsychores.2009.07.013


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