title: Depression and prehospital delay in the context of myocardial infarction.
abstract: OBJECTIVE
  The purpose of this study was to evaluate how depression might influence treatment-seeking behaviors in the context of evolving symptoms of myocardial infarction (MI).
  
  
  METHODS
  Post-MI patients (n = 433) completed a retrospective self-report measure of depressive symptoms with regard to the 2 weeks preceding the MI and a semistructured interview regarding their treatment-seeking behaviors.
  
  
  RESULTS
  Survival analyses found that delay in seeking treatment for acute MI symptoms was observed among participants who (1) attributed their symptoms to noncardiac causes, (2) perceived their symptoms to be relatively mild, (3) experienced gastrointestinal distress, (4) did not experience sweating, and (5) reported being depressed during the 2 weeks before hospitalization. Subsidiary analyses indicated that, among depressive symptoms, sleep disturbance and fatigue predicted delay.
  
  
  CONCLUSIONS
  Depression warrants further attention as a variable that may influence treatment seeking for MI symptoms. Results highlight the need to adequately screen for and treat depression among persons at risk for MI.
authors.affiliation: Department of Psychology, University of Iowa, Iowa City, IA 52242, USA.
authors.forename: James
authors.initials: J
authors.lastname: Bunde
authors.forename: René
authors.initials: R
authors.lastname: Martin
mesh_terms: D000368:Aged; D003863:Depression / Q000150:complications / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D012189:Retrospective Studies; D013997:Time Factors