Types of depression in patients with coronary heart disease: Results from the THORESCI study
H Hermans1, P Lodder2, N Kupper1
1Center of Research on Psychological disorders in Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, the Netherlands.
Insights
This study identified three depressive subtypes in coronary heart disease (CHD) patients: depressed, fatigued, and non-depressed. Medical and psychiatric factors increase depression risk, while fatigue is linked to cardiovascular procedures and lifestyle.
Area of Science:
- Cardiology
- Psychiatry
- Public Health
Background:
- Coronary heart disease (CHD) and depression are prevalent and interconnected, yet the exact nature of their relationship requires further elucidation.
- Identifying distinct depressive subtypes within CHD patient populations may offer crucial insights into this complex bidirectional association.
Purpose of the Study:
- To investigate and define specific depressive subtypes among individuals diagnosed with coronary heart disease (CHD).
- To characterize these subtypes based on demographic, medical, psychiatric, and cardiovascular risk factors.
Main Methods:
- Latent class analysis was performed on data from 1530 CHD patients using nine depression symptom indicators from PHQ-9 and BDI-II.
- The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) criteria guided symptom representation.
- Model fit was confirmed via double cross-validation, with classes analyzed against various risk factors.
Main Results:
- A three-class model best fit the data: depressed (5.4%), fatigued (13.5%), and non-depressed (81.1%).
- Depression risk increased with medical comorbidities, psychiatric history, negative affectivity, and anxiety.
- Fatigue was associated with elective percutaneous coronary intervention (PCI), physical inactivity, medical comorbidities, psychiatric history, and anxiety.
Conclusions:
- Patients with CHD and co-occurring medical or psychiatric conditions warrant targeted support to mitigate or prevent depressive and fatigue symptoms.
- Future research should aim to include larger cohorts with diverse depressive symptom presentations in CHD populations.
Background:
Both coronary heart diseases (CHD) and depression are highly prevalent and bidirectionally related. The precise nature of this relationship remains unclear. Defining depressive subtypes could help unravel this relationship. Therefore, the aim of this study was to explore depressive subtypes in patients with CHD.
Methods:
1530 patients (21.3 % women, mean age: 64.7 years (SD = 10.1)) were included in latent class analysis with nine indicators derived from the PHQ-9 and BDI-II representing symptoms of depression as described in the DSM-5 criteria. The best-fitting latent class model was confirmed with double cross-validation. Classes were characterized using demographic, medical, psychiatric, and cardiovascular (risk) factors.
Results:
A 3-class model demonstrated the best fit to the data, resulting in a depressed (5.4 %), fatigued (13.5 %), and non-depressed class (81.1 %). Having medical comorbidities, a history of psychiatric problems, negative affectivity, and anxiety symptoms increased the odds of belonging to the depressed group (OR 3.02, 95%CI 1.19-7.68, OR 3.61, 95%CI 1.44-9.02, OR 1.16, 95%CI 1.04-1.30, and OR 1.89, 95%CI 1.66-2.15, respectively). Belonging to the fatigued group was associated with increased odds of having an elective PCI (OR 2.12, 95%CI 1.27-3.55), insufficient physical activity (OR 2.19, 95%CI 1.20-3.99), comorbid medical conditions (OR 2.15, 95%CI 1.21-3.81), a history of psychiatric problems (OR 2.25, 95%CI 1.25-4.05), and anxiety symptoms (OR 1.48, 95%CI 1.34-1.63) compared with the non-depressed group.
Limitations:
Future studies should include more people with depressive symptoms.
Conclusions:
Patients with CHD and medical or psychiatric risk factors should be offered support to decrease or prevent depressive or fatigue symptoms.
More Related Videos
18:11A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
Published on: December 28, 2012
04:38A Middle Cerebral Artery Occlusion Technique for Inducing Post-stroke Depression in Rats
Published on: May 22, 2019
Related Concept Videos
01:27Depressive Disorders: Etiology
Biological Factors in Depression
Biological predispositions significantly influence the risk of developing depressive disorders. Genetic studies highlight the role of variations in the serotonin transporter...
01:27Depressive Disorders: MDD and Dysthymia
01:27Psychoneuroimmunology: Cardiovascular Disease
A key area of focus in PNI is the relationship between stress and coronary...
01:17Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
01:18Depression: Overview
01:03Long-term Depression
Calcium Ion Concentration Mechanism
If over...