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Clinical correlates of depression following myocardial infarction
J J Strik1, A Honig, R Lousberg
1Academic Hospital Maastricht/Maastricht University, The Netherlands.
Insights
Identifying patients at risk for post-myocardial infarction (MI) depression is crucial. Easily measurable factors like benzodiazepine use, cardiac complications, depression history, and smoking cessation difficulties can predict post-MI depression.
Area of Science:
- Cardiology
- Psychiatry
- Clinical Medicine
Background:
- Post-myocardial infarction (MI) depression is linked to increased mortality, particularly within 18 months.
- Early identification of patients at risk for post-MI depression is vital for timely intervention.
Purpose of the Study:
- To investigate easily attainable clinical variables as potential correlates for post-MI depression.
- To identify risk factors for depression following a first myocardial infarction.
Main Methods:
- A cohort of 173 first-MI patients was assessed using the SCL-90 depression scale and DSM-III-R criteria.
- Four pre-selected variables were examined: benzodiazepine prescription, cardiac complications, depression history, and smoking cessation.
- 35 depressed patients were compared with 35 matched non-depressed patients.
Main Results:
- Univariate analysis indicated that cardiac complications (OR=2.14), benzodiazepine prescription (OR=3.67), depression history (OR=3.0), and inability to quit smoking (OR=4.5) were associated with post-MI depression.
- Multivariate analyses did not identify any of these factors as independent predictors.
Conclusions:
- Several readily measurable patient characteristics can help identify individuals at risk for post-MI depression.
- Further research is warranted to confirm the predictive value of these factors in relation to post-MI depression.
Objective:
Post-MI depression increases mortality, especially in the first 18 months after MI. Identifying patients at risk for post-MI depression is therefore important. In the present study we investigated possible correlates for post-MI depression on an a priori basis.
Method:
Based on the literature, four clinically easily attainable variables were selected as possible correlates for post-MI depression. These were prescription of benzodiazepines during acute hospitalization, cardiac complications during acute hospitalization, history of depression, and not being able to stop smoking within six months after MI. A consecutive cohort of 173 first-MI patients was screened with the SCL-90 depression scale and DSM-III-R criteria for major depression. Of this cohort 35 depressed patients were compared with 35 non-depressed post-MI patients, matched for gender, age, and severity of MI.
Results:
In univariate analyses, complications during hospitalisation (OR = 2.14; CI = 0.89-5.14), prescription of benzodiazepines (OR = 3.67; CI = 1.11-12.1), history of depression (OR = 3.0; CI = 0.87-10.4), and not being able to stop smoking (OR = 4.5; CI = 1.11-18.2) were clinical correlates for post-MI depression. Multivariate analyses showed that none of these variables were independent of the others in predicting depression.
Conclusions:
A number of easily measurable patient characteristics identify those MI-patients at risk of post-MI depression. Further investigations should focus on the predictive value of these factors in relation to post-MI depression.