在心肌梗塞后的第一年,社会支持,抑郁和死亡率
N Frasure-Smith1, F Lespérance, G Gravel
1Departments of Psychiatry and School of Nursing, McGill University, Montreal, Canada.
Circulation
|April 26, 2000
概括
心肌梗塞 (MI) 后的抑郁预测心脏死亡率,但社会支持可能缓冲这种风险. 高度的社会支持也可以改善后心脏病患者的抑郁症状.
科学领域:
- 心脏病学 心脏病学
- 精神病学是一个精神病学.
- 公共卫生 公共卫生
背景情况:
- 心肌梗塞 (MI) 后的抑郁症与长期心脏死亡率的增加有关.
- 社会支持也被认为是影响心脏病发作后患者预后的一个因素.
研究的目的:
- 为了研究基线抑郁症和社会支持之间的相互作用.
- 为了检查它们对心脏预后和抑郁症症状变化的综合影响,在第一年后MI.
主要方法:
- 887名患者在心脏病发作7天内完成了贝克抑郁 inventory (BDI) 和感知社会支持量表 (PSSS).
- 一年生存期和抑郁症症状变化通过随访访谈进行评估.
主要成果:
- 32%的患者表现出轻度至中度抑郁 (BDI ≥10).
- 较高的BDI得分预测了心脏病死亡率 (P=0.0006),而PSSS得分没有直接预测存活率.
- 一个显著的相互作用 (P=0.016) 显示,更高的社会支持减弱了抑郁症和心脏病死亡率之间的关联.
结论:
- 后心脏病发作抑郁症预测1年的心脏病死亡率,但社会支持不是直接的生存预测因素.
- 高水平的社会支持缓解了抑郁症对死亡率的负面影响.
- 增加的社会支持与幸存者抑郁症症状的更大改善有关,这可能解释了其保护作用.
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