Depressive vulnerabilities predict depression status and trajectories of depression over 1 year in persons with acute coronary syndrome.
Gen Hosp Psychiatry
; 33(3): 224-31, 2011.
Article
in En
| MEDLINE
| ID: mdl-21601718
ABSTRACT
OBJECTIVE:
Depression is prevalent in patients hospitalized with acute coronary syndrome (ACS). We determined whether theoretical vulnerabilities for depression (interpersonal life events, reinforcing events, cognitive distortions, Type D personality) predicted depression, or depression trajectories, post-hospitalization.METHODS:
We followed 375 ACS patients who completed depression scales during hospital admission and at least once during three follow-up intervals over 1 year (949 observations). Questionnaires assessing vulnerabilities were completed at baseline. Logistic regression for panel/longitudinal data predicted depression status during follow-up. Latent class analysis determined depression trajectories. Multinomial logistic regression modeled the relationship between vulnerabilities and trajectories.RESULTS:
Vulnerabilities predicted depression status over time in univariate and multivariate analysis, even when controlling for baseline depression. Proportions in each depression trajectory category were as follows persistent (15%), subthreshold (37%), never depressed (48%). Vulnerabilities independently predicted each of these trajectories, with effect sizes significantly highest for the persistent depression group.CONCLUSIONS:
Self-reported vulnerabilities - stressful life events, reduced reinforcing events, cognitive distortions, personality - measured during hospitalization can identify those at risk for depression post-ACS and especially those with persistent depressive episodes. Interventions should focus on these vulnerabilities.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Depression
/
Acute Coronary Syndrome
Type of study:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Gen Hosp Psychiatry
Year:
2011
Document type:
Article
Affiliation country:
Ireland