Depression as a predictor of return to work in patients with coronary artery disease

The importance of depression in coronary artery disease (CAD) outcomes is being increasingly recognized. The aim of this study was to investigate the power of depression as a predictor of return to work, both at full time and at reduced working hours, within 12 months of participation in a behaviorally oriented rehabilitation program in Sweden. The sample comprised 198 employed patients who had recently experienced an acute myocardial infarction (AMI, n=85), or had been treated with coronary by-pass surgery (CABG, n=73) or coronary angioplasty (PTCA, n=40). The results showed that clinical depression before intervention (>or=16 as measured by the Beck Depression Inventory) exerted a great influence on work resumption both at full-time (odds ratio 9.43, CI=3.15-28.21) and at reduced working-hours (odds ratio 5.44, CI=1.60-18.53), while mild depression (BDI 10-15) influenced only work resumption at full-time (odds ratio 2.89, CI=1.08-7.70). Education and, at full-time hours, age also predicted work resumption. This highlights the importance of depressive symptoms in relation to return to work after a CAD event. More research is needed in order to elaborate the degree to which treatment of depression enhances work resumption rates.