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The effect of major depression on functional status in patients with coronary artery disease
D C Steffens1, C M O'Connor, W J Jiang
1Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina 27710, USA.
Insights
Major depression significantly impacts functional status in patients with coronary artery disease (CAD). Depressed CAD patients are more likely to experience deficits in daily living activities, highlighting the need for integrated care.
Area of Science:
- Cardiology
- Psychiatry
- Gerontology
Background:
- Coronary artery disease (CAD) is a leading cause of mortality and morbidity.
- Functional status is a critical determinant of quality of life in patients with chronic conditions.
- The impact of major depression on functional status in CAD patients remains incompletely understood.
Purpose of the Study:
- To investigate the association between major depression and functional status in patients diagnosed with coronary artery disease.
- To identify predictors of functional disability in this patient population.
Main Methods:
- A cohort of 335 inpatients with coronary artery disease (CAD) was evaluated.
- Participants were free of neurological conditions like dementia and Parkinson's disease.
- Functional status was assessed using scales for instrumental and self-maintenance activities of daily living (ADL), alongside depression screening via the Duke Depression Evaluation Schedule.
Main Results:
- Twenty-seven patients (8.1%) met DSM-IV criteria for major depression.
- Depressed patients were over twice as likely to report deficits in self-maintenance ADLs.
- Major depression, female gender, older age, and higher medical illness severity predicted functional disability in both self-maintenance and instrumental ADLs.
Conclusions:
- Major depression is significantly associated with functional disability in patients with coronary artery disease.
- Further research is warranted to explore the efficacy of antidepressant treatment on both mood and function in CAD patients.
Objective:
To examine the effect of major depression on reported functional status in a group of patients with coronary artery disease (CAD).
Setting:
An inpatient cardiology service.
Participants:
Three hundred thirty-five inpatients with coronary artery disease who were free of dementia, Parkinson's disease, and other primary neurological illnesses.
Measurements:
Duke Depression Evaluation Schedule, a structured psychiatric interview which included the Diagnostic Interview Schedule depression subscale, the Cumulative Illness Rating Scale, and two scales for measuring instrumental and self-maintenance activities of daily living.
Results:
Twenty-seven subjects met DSM-IV criteria for major depression. Compared with subjects without major depression, depressed subjects were more than twice as likely to report a self-maintenance ADL deficit and were significantly more likely to report an IADL deficit than were nondepressed subjects (93 vs 71%). In regression models, female gender, older age, greater medical illness severity, and presence of major depression were significant predictors of self-maintenance ADL disability; and female gender, older age, greater medical severity, and presence of major depression significantly predicted greater IADL impairment.
Conclusion:
The presence of major depression was associated with functional disability in patients with CAD. Further research is needed to clarify whether antidepressant treatment significantly impacts both affective symptoms and functional status in patients with coronary heart disease.