Explicating links between acute coronary syndrome and depression: study design and methods.
OBJECTIVE
To describe a regional study seeking to replicate the suggested strong links whereby lifetime and post-coronary infarction depression are associated with a significant increase in mortality and cardiac morbidity, and consider the comparative influence of both depression and anxiety.


METHODS
We detail relevant international studies and describe both the methodology as well as baseline and 1-month data from our study.


RESULTS
Over a 3-year period we recruited 489 subjects admitted to a Sydney cardiac unit with an Acute Coronary Syndrome (ACS), and assessed by a range of cardiac variables and measures of current and lifetime depression. Ninety-eight per cent of the sample were assessed one month after baseline recruitment to establish depression rates. Long-term outcome reviews of mortality and morbidity and hospitalization rates are proceeding. For those subjects who were depressed in the post-ACS period and, even more so for those who had experienced lifetime depression, distinctly higher scores on anxiety variables (and lifetime caseness for anxiety disorders) were established.


CONCLUSIONS
The strong interdependence between anxiety and depression in this sample of patients admitted with an ACS will allow examination of the comparative extent to which expressions of 'depression' and 'anxiety' contribute to post-ACS morbidity.
School of Psychiatry, University of New South Wales, and Black Dog Institute, Prince of Wales Hospital, Randwick, Sydney, Australia. g.parker@unsw.edu.au
Gordon
G
Parker
Gabriella
G
Heruc
Therese
T
Hilton
Amanda
A
Olley
Heather
H
Brotchie
Dusan
D
Hadzi-Pavlovic
Catherine
C
Owen
Cheryl
C
Friend
Warren F
WF
Walsh
D000368:Aged; D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D003327:Coronary Disease / Q000453:epidemiology* / Q000523:psychology*; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000523:psychology*; D009517:New South Wales; D013223:Statistics as Topic; D013577:Syndrome