社会的支援,うつ病,心筋梗塞の翌年の死亡率
N Frasure-Smith1, F Lespérance, G Gravel
1Departments of Psychiatry and School of Nursing, McGill University, Montreal, Canada.
Circulation
|April 26, 2000
まとめ
心筋梗塞 (MI) の後のうつ病は心臓の死亡率を予測しますが,社会的サポートはこのリスクを緩衝することができます. また,高い社会的サポートは,心筋梗塞後の患者のうつ症状を改善します.
科学分野:
- 心臓病学 心臓病学
- 精神科医は精神病を患っている.
- 公衆衛生は公衆衛生である.
背景:
- 心筋梗塞 (MI) 以後のうつ病は,長期的な心臓死亡率の増加と関連しています.
- また,社会的なサポートは,心筋梗塞後の患者の予後に影響を与える要因として認識されています.
研究 の 目的:
- ベースラインのうつ病と社会的サポートの相互作用を調査する.
- 心臓発作後の1年目の心臓発作の予後とうつ病の症状の変化に対するそれらの効果の組み合わせを検証する.
主な方法:
- 887人の患者が心筋梗塞の7日以内にベック・デプレッション・インベントリー (BDI) と認知社会支援スケール (PSSS) を完了しました.
- 1年間の生存率とうつ病症状の変化は,フォローアップインタビューを通じて評価されました.
主要な成果:
- 32%の患者が軽度から中等度のうつ病 (BDI ≥10) を示した.
- 高いBDIスコアは心疾患による死亡率 (P=0.0006) を予測し,PSSSスコアは生存率を直接予測しなかった.
- 重要な相互作用 (P=0.016) は,より高い社会的サポートがうつ病と心臓病死亡率との関連を弱めたことを示しました.
結論:
- 発心筋梗塞後のうつ病は1年後の心疾患による死亡率を予測しますが,社会的サポートは生存率の直接的な予測要因ではありません.
- 高い社会的サポートは,うつ病が死亡率に与える負の影響を緩衝する.
- 社会的支援の増加は,生存者のうつ病症状のより大きな改善と関連しており,潜在的にその保護効果を説明しています.
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