Depression and social support in elderly patients with cardiac disease
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K R Krishnan1, L K George, C F Pieper
1Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA.
Insights
Major depression in elderly cardiac patients is linked to fewer social supports and more negative life events. These social factors remain significant even with underlying medical conditions.
Area of Science:
- Cardiology
- Psychiatry
- Geriatrics
Background:
- Depression is prevalent in cardiac patients.
- Psychosocial factors like negative life events and social support influence depression.
- The role of these factors in medically ill patients, specifically elderly cardiac patients, requires investigation.
Purpose of the Study:
- To examine the relationship between social support, negative life events, and depression in elderly patients with cardiac disease.
- To test if negative life events are higher and social support is lower in depressed cardiac patients.
Main Methods:
- Utilized the Duke Depression Evaluation Schedule for the Elderly.
- Assessed mood disorders, life events, and social support using modified Diagnostic Interview Schedule criteria.
- Examined two hypotheses regarding negative life events and social support in major depression.
Main Results:
- Major depression was associated with a higher number of negative life events.
- Lower subjective social support was observed in patients with major depression.
- These associations remained significant after controlling for age, sex, and race.
Conclusions:
- Subjective social support and negative life events are significant factors in the development of major depression among elderly cardiac patients.
- Social factors play a crucial role in the etiology of depression, even in the presence of significant medical illness.
Background:
Depression is common among patients with cardiac disease. A number of psychosocial factors may affect the relationship between physical health and depression. There is evidence from the psychiatric literature suggesting that negative life events and social support are important factors in the development and outcome of depression. It is unknown if these factors are important in the context of depression in medically ill patients. Thus it is important to examine the relationship among social support, negative life events, and the presence of depression in elderly patients with cardiac disease.
Methods:
Patients with coronary artery disease were assessed with the Duke Depression Evaluation Schedule for the Elderly. This includes the mood and anxiety disorder section of the Diagnostic Interview Schedule modified for Diagnostic and Statistical Manual of Mental Disorders diagnoses, life events, and multidimensional assessment of social support. Two hypotheses were tested: (1) the number of concurrent negative life events will be higher in patients with coronary artery disease with major depression than those without depression, and (2) social support will be less in patients with major depression than in those without.
Results:
Presence of major depression was associated with increased negative life events and lowered subjective social support after accounting for age, sex, and race.
Conclusions:
The finding that subjective social support and negative life events are related to major depression suggests that even in the context of medical illness, social factors are still important in the development of major depression.
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