Association of baseline anxiety with depression persistence at 6 months in patients with acute cardiac illness.

Abstract:

OBJECTIVE:To assess the association of baseline anxiety with depression persistence and change in depressive symptoms 6 months after cardiac hospitalization. METHODS:Data were analyzed from 137 depressed patients hospitalized on inpatient cardiac units for acute coronary syndrome, decompensated heart failure, or arrhythmia and who were enrolled in a randomized trial of collaborative care depression management. Subjects' demographic, medical, and psychiatric information at baseline was compiled. Measures of health-related quality of life, cardiac symptoms, and psychiatric symptoms, including the Hospital Anxiety and Depression Scale-anxiety subscale (HADS-A) for anxiety, were obtained at baseline and serially during a 6-month follow-up period. The association between baseline HADS-A score and depression persistence (<50% reduction in depressive symptoms on the Patient Health Questionnaire-9) at 6 months was assessed by multivariate logistic regression accounting for the effects of multiple relevant medical and psychological covariates. The association between baseline HADS-A score and improvement in depressive symptoms (Patient Health Questionnaire-9) from baseline at 6 months was assessed by linear regression accounting for the same covariates. RESULTS:Baseline HADS-A score was independently associated with depression persistence at 6 months (odds ratio = 1.11, 95% confidence interval = 1.01-1.22, p = .03). Likewise, higher baseline HADS-A score was associated with less improvement in depressive symptoms at 6 months (β = -0.34, p = .01). CONCLUSIONS:Among a cohort of depressed cardiac patients, higher baseline anxiety score was linked with lesser improvement in depressive symptoms and increased likelihood of depression persistence at 6 months, independent of multiple relevant covariates. TRIAL REGISTRATION:clinicaltrials.gov Identifier: NCT00847132.

journal_name

Psychosom Med

journal_title

Psychosomatic medicine

authors

Celano CM,Mastromauro CA,Lenihan EC,Januzzi JL,Rollman BL,Huffman JC

doi

10.1097/PSY.0b013e31823d38bc

subject

Has Abstract

pub_date

2012-01-01 00:00:00

pages

93-9

issue

1

eissn

0033-3174

issn

1534-7796

pii

PSY.0b013e31823d38bc

journal_volume

74

pub_type

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