Stability and Transitions of Depressive Subtypes and Their Association With Patient Characteristics in Patients With
Insights
A significant portion of patients with coronary heart disease (CHD) experience persistent or delayed depressive and fatigue symptoms post-percutaneous coronary intervention (PCI). These symptoms can emerge even after cardiac rehabilitation concludes.
Area of Science:
- Cardiology
- Psychiatry
- Health Psychology
Background:
- Coronary heart disease (CHD) significantly impacts patients' mental health.
- Understanding the trajectory of depressive symptoms post-percutaneous coronary intervention (PCI) is crucial for patient outcomes.
Purpose of the Study:
- To investigate the development, persistence, and recovery of depressive symptoms in patients with CHD after PCI.
- To identify medical and psychosocial factors influencing these symptom patterns.
Main Methods:
- Latent transition analysis was used to study depressive subtypes in 1530 patients post-PCI.
- Symptom patterns were assessed at one month, six months, one year, and two years using PHQ-9 and BDI-II indicators.
- Medical, psychosocial, and cardiovascular factors were analyzed in relation to symptom trajectories.
Main Results:
- At one month post-PCI, patient classes included non-depressed (79.9%), depressed (5.7%), and fatigued (14.4%).
- Major transition patterns were stable non-depressed (71.6%), chronic fatigue (11.6%), and delayed onset of symptoms (6.3%).
- Lower cardiac self-efficacy and higher anxiety were linked to chronic fatigue.
Conclusions:
- Most patients with CHD do not have chronic depressive or fatigued symptoms.
- A notable minority experience these symptoms, which can appear after standard cardiac rehabilitation.
Objective:
The aim of this study was to explore the development, persistence, and recovery of depressive symptoms in patients with coronary heart disease (CHD) and how medical and psychosocial factors may influence such transition patterns.
Methods:
In total, 1530 patients (21.3% women, mean age: 64.7±10.1 y) who received a percutaneous coronary intervention (PCI) were included. Stability and transition patterns of depressive subtypes at 1 month, 6 months, 1 year, and 2 years after PCI were studied using latent transition analysis in MPlus, with 9 indicators derived from the PHQ-9 and BDI-II, and characterized using medical, psychosocial, and cardiovascular factors. Methods were preregistered: osf.io/xay2h/.
Results:
A nondepressed (79.9%), depressed (5.7%), and fatigued (14.4%) class was found at 1 month after PCI. Transition patterns comprised no depressive symptoms (71.6%), chronic fatigue (11.6%), a delayed onset of fatigue/depressive symptoms (6.3%), recovery of symptoms (2.5%), and chronic depression (1.4%). Multiple factors were related to the different patterns, eg, less cardiac self-efficacy (OR=1.06, 95% CI: 1.03-1.08) and more anxiety symptoms (OR=1.35, 95% CI: 1.25-1.46) were associated with the chronically fatigued group compared with the stable nondepressed group.
Conclusions:
The majority of patients with CHD do not report chronic depressed or fatigued symptoms. However, a substantial part does, and these symptoms may emerge after regular cardiac rehabilitation is finished.
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