Efficient assessment of depressive symptoms and their prognostic value in myocardial infarction patients |
| |
| Authors: | Johan Denollet Elisabeth J Martens Otto RF Smith Matthew M Burg |
| |
| Institution: | 1. Central Hospital of Augsburg, MONICA/KORA Myocardial Infarction Registry, Stenglinstr. 2, D-86156 Augsburg, Germany;2. Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Institute of Epidemiology II, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany;3. Hospital of Nördlingen, Department of Internal Medicine/Cardiology, Stoffelsberg 4, 86720 Nördlingen, Germany;4. Central Hospital of Augsburg, Department of Internal Medicine I — Cardiology, Stenglinstr. 2, D-86156 Augsburg, Germany;1. Department of Cardiothoracic Surgery and Anesthesiology, Karolinska University Hospital, Stockholm, Sweden;2. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden;3. Department of Emergency Medicine, Karolinska University Hospital, Stockholm, Sweden;4. Department of Internal Medicine, Karolinska Institutet, Stockholm, Sweden;1. Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Quebec, Canada;2. Department of Psychiatry, McGill University, Montréal, Quebec, Canada;3. Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Quebec, Canada;4. Department of Medicine, McGill University, Montréal, Quebec, Canada;5. Department of Educational and Counselling Psychology, McGill University, Montréal, Quebec, Canada;6. Department of Psychology, McGill University, Montréal, Quebec, Canada;7. School of Nursing, McGill University, Montréal, Quebec, Canada;8. Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA;1. Department of Psychiatry, Faculty of Medicine, Selcuk University, Konya 42075, Turkey;2. Faculty of Medicine, Selcuk University, Konya 42075Turkey |
| |
| Abstract: | BackgroundIdentification of post-myocardial infarction (MI) depressive symptoms is a major concern and clinicians are in need of a short, easy-to-use assessment tool for this population. We evaluated the utility and prognostic power of a brief 10-item version of the Beck Depression Inventory (BDI10) in post-MI patients.MethodsPatients (n = 416) were assessed on demographic/clinical variables and completed the BDI10, BDI-21 and STAI (anxiety symptoms) two months post-MI. The end point was a composite of cardiac death and recurrent MI. The average follow-up period was 2.7 years and follow-up data was complete for all patients.ResultsFactor analysis of the BDI10 yielded a one-factor model. The BDI10 had good reliability (α = .82) and correlated highly (r = .89) with the standard BDI measure of depressive symptoms; a BDI-derived proxy measure of the BDI10 correlated .94 with the actual BDI10 score. There were 41 events attributable to cardiac death (n = 24) or recurrent MI (n = 20). The mean level of depressive symptoms as measured by the BDI10 was significantly higher in patients who experienced an event (4.3 ± 4.4) compared with event-free patients (2.6 ± 2.8); p = 0.015. The BDI10 (HR:1.18; 95%CI:1.08–1.29, p < 0.0001) independently predicted death/recurrent MI adjusting for disease severity. Age, BMI and cardiac history were also independent predictors of death/recurrent MI in these analyses.LimitationsThe low number of women (22%), relatively healthy sample (mean LVEF = 52%) and lack of a structured interview as gold standard for assessment of depression.ConclusionsThe BDI10 is a brief, valid, and easy-to-use self-report measure of depressive symptoms that predicts post-MI outcomes and hence can be used clinically for risk stratification purposes, while reducing assessment burden. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
