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Depression and self-reported physical health in patients with coronary disease: mediating and moderating factors

M D Sullivan1, A Z LaCroix, J E Russo

  • 1Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle 98195, USA. sullimar@u.washington.edu

Psychosomatic Medicine
|April 9, 2001
PubMed

Insights

Depression significantly impacts physical health in coronary disease patients. This effect is mediated by physical symptoms, psychological traits like positive affect, and spousal support, highlighting multifaceted influences on perceived health.

Area of Science:

  • Cardiology
  • Psychology
  • Health Services Research

Background:

  • Depression is a known comorbidity in patients with coronary heart disease (CHD).
  • The interplay between depression and self-reported physical health in CHD patients is complex and influenced by various factors.

Purpose of the Study:

  • To investigate how patient-centered factors modify the relationship between depression and self-reported physical health in individuals with coronary disease.
  • To identify specific mediators influencing perceived physical health in this population.

Main Methods:

  • Prospective cohort study involving 111 patients with angiographically confirmed coronary disease.
  • Utilized multiple hierarchical regression models to analyze data collected over 5 years.
  • Examined the influence of physical symptoms, psychological states/traits, and spousal support on the depression-physical health relationship.

Main Results:

  • Depression remained a significant predictor of physical health across all models.
  • Physical symptoms (angina, fatigue), psychological factors (positive affect, novelty seeking), and spousal support substantially mediated the effect of depression.
  • The overall model, including these factors, explained 65% of the variance in physical health.

Conclusions:

  • Physical symptoms, personality traits, and social support significantly mediate the impact of depression on self-reported physical health in coronary disease patients.
  • Positive affect and novelty seeking demonstrated a more pronounced effect on physical health when depression levels were higher.
  • Perceived physical health in CHD patients is influenced by a wide array of factors beyond the disease's objective severity.
Abstract

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