title: Contribution of depression and anxiety to impaired health-related quality of life following first myocardial infarction.
abstract: BACKGROUND
  The extent to which depression impairs health-related quality of life (HRQoL) in the physically ill has not been clearly established.
  
  
  OBJECTIVE
  To quantify the adverse influence of depression and anxiety, assessed at the time of first myocardial infarction and 6 months later, on the physical aspect of HRQoL 12 months after the infarction.
  
  
  METHODS
  In all, 260 in-patients, admitted following first myocardial infarction, completed the Hospital Anxiety and Depression Scale and the Medical Outcomes Study SF-36 assessment before discharge and at 6- and 12-month follow-up.
  
  
  RESULTS
  Depression and anxiety 6 months after myocardial infarction predicted subsequent impairment in the physical aspects of HRQoL (attributable adjusted R(2)=9%, P<0.0005). These negative effects of depression and anxiety on outcome were mediated by feelings of fatigue. Depression and anxiety present before myocardial infarction did not predict HRQoL 12 months after myocardial infarction.
  
  
  CONCLUSIONS
  Detection and treatment of depression and anxiety following myocardial infarction improve the patient's health-related quality of life.
authors.affiliation: Department of Psychiatry, Rawnsley Building, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK. chris.dickens@manchester.ac.uk
authors.forename: C M
authors.initials: CM
authors.lastname: Dickens
authors.forename: L
authors.initials: L
authors.lastname: McGowan
authors.forename: C
authors.initials: C
authors.lastname: Percival
authors.forename: B
authors.initials: B
authors.lastname: Tomenson
authors.forename: L
authors.initials: L
authors.lastname: Cotter
authors.forename: A
authors.initials: A
authors.lastname: Heagerty
authors.forename: F H
authors.initials: FH
authors.lastname: Creed
mesh_terms: D000367:Age Factors; D001008:Anxiety Disorders / Q000523:psychology*; D003866:Depressive Disorder / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology; D012307:Risk Factors; D011795:Surveys and Questionnaires