Related Experiment Videos

Depressive symptoms and survival of patients with coronary artery disease

J C Barefoot1, B H Brummett, M J Helms

  • 1Behavioral Medicine Research Center, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina 27710, USA. foot@acpub.duke.edu

Psychosomatic Medicine
|January 4, 2001
PubMed

Insights

High levels of depressive symptoms, particularly negative affect and hopelessness, significantly predict mortality risk in patients with coronary disease. These factors are especially critical for younger individuals, independent of disease severity.

Area of Science:

  • Cardiology
  • Psychiatry
  • Public Health

Background:

  • Elevated depressive symptoms are linked to increased mortality in coronary heart disease patients.
  • Understanding the differential impact of specific depressive symptom clusters is crucial for risk stratification.

Purpose of the Study:

  • To investigate the relative effectiveness of distinct depressive symptom groups in predicting survival among coronary heart disease patients.
  • To examine the independent predictive value of hopelessness and negative affect on mortality.

Main Methods:

  • 1250 coronary heart disease patients completed depression questionnaires (Zung Self-Rating Depression Scale).
  • Factor analysis categorized symptoms into Well-Being, Negative Affect, Somatic, and Appetite.
  • Mortality follow-up for cardiac disease occurred annually for up to 19.4 years.

Main Results:

  • Well-Being, Negative Affect, and Somatic symptoms significantly predicted survival.
  • Negative Affect demonstrated a stronger association with mortality in younger patients.
  • Hopelessness independently predicted survival, with a relative risk of 1.5.

Conclusions:

  • Depressive affect and hopelessness are key predictors of survival in coronary heart disease patients.
  • These psychological factors are independent of disease severity and somatic symptoms.
  • The impact of depressive symptoms on survival may be more pronounced in younger individuals.
Abstract

Related Concept Videos

Coronary Artery Disease III: Clinical Manifestations01:30

Coronary Artery Disease III: Clinical Manifestations

Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
Depressive Disorders: MDD and Dysthymia01:27

Depressive Disorders: MDD and Dysthymia

Depressive disorders are a group of mental health conditions characterized by pervasive feelings of sadness, diminished pleasure in life, and a significant impact on daily functioning. These conditions are most prevalent in individuals during their 30s and affect women at twice the rate of men. Contrary to popular belief, younger individuals are generally more susceptible to these disorders than older adults. Two key types of depressive disorders include Major Depressive Disorder (MDD) and...
Acute Coronary Syndrome V: Nursing Management01:26

Acute Coronary Syndrome V: Nursing Management

Nursing Assessment:Nursing management of acute coronary syndrome (ACS) involves taking the patient's history, focusing on primary complaints such as chest pain, dyspnea, and excessive sweating (diaphoresis), as well as other symptoms like back or jaw pain, nausea, vomiting, palpitations, dizziness, and fatigue. The nurse also reviews the patient's history of cardiac events, risk factors such as hypertension, diabetes, smoking, family history, and current medications.In the objective assessment,...
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...