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Time-dependent depression and anxiety symptoms as risk factors for recurrent cardiac events: findings from the UPBEAT-UK study.
Norton, Joanna; Pastore, Manuela; Hotopf, Matthew; Tylee, Andre; Mann, Anthony; Ancelin, Marie-Laure; Palacios, Jorge.
Afiliación
  • Norton J; Univ Montpellier, Inserm, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France.
  • Pastore M; Univ Montpellier, CNRS, Inserm, Biocampus UAR3426, Montpellier, France.
  • Hotopf M; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
  • Tylee A; South London and Maudsley NHS Foundation Trust, London, UK.
  • Mann A; Department of Health Services and Population Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
  • Ancelin ML; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
  • Palacios J; Univ Montpellier, Inserm, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France.
Psychol Med ; : 1-9, 2021 Feb 10.
Article en En | MEDLINE | ID: mdl-33565388
BACKGROUND: Depression is a well-known risk factor for recurrent cardiac events (RCEs) but findings are less consistent for anxiety, not previously reported on using a time-dependent approach. We aimed to study the prognostic effect of anxiety and depression symptom levels on RCEs. METHODS: Data (N = 595) were drawn from the UPBEAT-UK heart disease patient cohort with 6-monthly follow-ups over 3 years. Hospital Anxiety and Depression Scale symptoms were grouped into: agitation (three items), anxiety (four items), and depression (seven items) subscales. We performed two types of multivariate analyses using Cox proportional hazard models with delayed entry: with baseline variables (long-term analysis), and with variables measured 12-to-18 months prior to the event (short-term time-dependent analysis), as RCE risk factors. RESULTS: In the baseline analysis, both anxiety and depression, but not agitation, were separate RCE risk factors, with a moderating effect when considered jointly. In the short-term time-dependent analysis, elevated scores on the anxiety subscale were associated with increased RCE risk even when adjusted for depression [hazard ratio (95% confidence interval) 1.22 (1.05-1.41), p = 0.009]. Depression was no longer a significant predictor when adjusted for anxiety [1.05 (0.87-1.27), p = 0.61]. For anxiety, individual items associated with RCEs differed between the two approaches: item 5 'worrying thoughts' was the most significant long-term risk factor [1.52 (1.21-1.91), p = 0.0004] whereas item 13 'feelings of panic' was the most significant time-dependent short-term risk factor [1.52 (1.18-1.95), p = 0.001]. CONCLUSIONS: Anxiety is an important short-term preventable and potentially causal risk factor for RCEs, to be targeted in secondary cardiac disease prevention programmes.
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Texto completo: 1 Banco de datos: MEDLINE Tipo de estudio: Diagnostic_studies / Etiology_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Psychol Med Año: 2021 Tipo del documento: Article País de afiliación: Francia

Texto completo: 1 Banco de datos: MEDLINE Tipo de estudio: Diagnostic_studies / Etiology_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Psychol Med Año: 2021 Tipo del documento: Article País de afiliación: Francia