Relative lack of depressive cognitions in post-myocardial infarction depression.
BACKGROUND
Depression has been associated with adverse clinical events in myocardial infarction (MI) patients, but many questions about the nature of post-MI depression remain unanswered. We examined whether depressive cognitions characteristic of depression in psychiatric patients are also present in post-MI patients with major depression (MD).


METHODS
Non-depressed (n=40) and depressed (n=40) post-MI patients, and psychiatric outpatients (n=40) treated for clinical depression, matched on age and sex, were interviewed using a structured clinical interview to diagnose DSM-IV MD. All patients also completed the Beck Depression Inventory (BDI) and the Beck Cognition Checklist-Depression subscale (CCL-D).


RESULTS
Mean levels of depressive cognitions were considerably higher in depressed psychiatric patients compared with depressed post-MI patients (34.9 versus 28.0; p=.013), and higher in depressed post-MI patients compared with non-depressed post-MI patients (28.0 versus 17.8; p<.0001), adjusted for age, sex, educational level, and marital status. Younger age (p=.024), absence of a partner (p=.016) and depressed psychiatric status (p=.016) were independently associated with depressive cognitions. Psychiatric patients also had higher mean levels of depressive symptoms as compared to depressed post-MI patients (25.1 versus 17.8; p=.001).


CONCLUSIONS
This study is based on a cross-sectional design.


CONCLUSIONS
The symptom presentation of MD in post-MI patients is both quantitatively and qualitatively different from that seen in psychiatric patients, suggesting that depressive symptoms in post-MI patients differ in content from those in psychiatric patients. These findings could have important consequences for the design and contents of therapeutic programs for treating depression in post-MI patients.
Martens
Elisabeth J
EJ
Department of Medical Psychology, Center of Research on Psychology in Somatic diseases, Tilburg University, The Netherlands. E.J.Martens@uvt.nl
Denollet
Johan
J
Pedersen
Susanne S
SS
Scherders
Mark
M
Griez
Eric
E
Widdershoven
Jos
J
Szabó
Balázs
B
Bonnier
Hans
H
Appels
Ad
A
D000328:Adult; D000368:Aged; D001364:Awareness; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009203:Myocardial Infarction / Q000523:psychology*; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics / Q000706:statistics & numerical data; D012649:Self Concept; D012803:Sick Role