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Depression after myocardial infarction is a risk factor for declining health related quality of life and increased disability and cardiac complaints at 12 months
  1. P de Jonge*,
  2. T A Spijkerman,
  3. R H S van den Brink,
  4. J Ormel
  1. Department of Psychiatry, University of Groningen, Groningen, the Netherlands
  1. Correspondence to:
    Dr Peter de Jonge
    Department of Psychiatry, University of Groningen, PO Box 30.001, 9700 RB Groningen, Netherlands; p.de.jonge{at}med.rug.nl

Abstract

Objective: To study the prospective effects of post-myocardial infarction (MI) depressive disorder on health status, including self reported cardiac symptoms, disability, and health related quality of life, at 12 months after MI while controlling for cardiac condition and health status at three months after MI.

Methods: Longitudinal study of a cohort of 468 adults with MI recruited from four hospitals in the north of the Netherlands between September 1997 and September 2000. Assessment of depressive disorder in the year after MI according to International classification of disease, 10th revision criteria. Assessment of health status at three and 12 months by the RAND 36 item health survey, the health complaints scale, self rated cardiac complaints, and disability.

Results: Patients with post-MI depressive disorder were more likely than those without to have poor quality of life, more health complaints, more cardiac complaints, and more disability at 12 months’ follow up. In multivariate analyses adjusted for cardiac condition, health status at three months, age, sex, and pre-MI depression, the prospective association of post-MI depression with poor health status remained for most of the indicators. Severity of the post-MI depression further contributed to aspects of poor health status.

Conclusions: In a prospective study design, post-MI depression had strong effects on poor health status exceeding the effects of cardiac condition and its short term consequences. Efforts to improve health status after MI should therefore include standard assessment and guideline based treatment of post-MI depressive disorder.

  • BDI, Beck depression inventory
  • CI, confidence interval
  • CIDI-Auto, composite international diagnostic interview
  • HCS, health complaints scale
  • IQOLA, international quality of life assessment
  • LVEF, left ventricular ejection fraction
  • MI, myocardial infarction
  • OR, odds ratio
  • QoL, quality of life
  • SPECT, single photon emission computed tomography
  • depression
  • myocardial infarction
  • health status
  • quality of life
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Footnotes

  • * Also Graduate Research School Behaviour, Cognition and Neurosciences (BCN), Graduate Research School Experimental Psychopathology (EPP), and the Department of Internal Medicine, Academic Hospital Groningen

  • Also BCN and EPP

  • Published Online First 12 May 2005

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