title: Self-rated health among women with coronary disease: depression is as important as recent cardiovascular events.
abstract: BACKGROUND
  Prior studies have shown an association between depression and self-rated health among patients with coronary disease. However, the magnitude of the effect of depression on self-rated health compared with that of major clinical events is unknown. Our main objective was to clarify the association between depression and self-rated health using longitudinal data.
  
  
  METHODS
  We performed a prospective cohort study of 2675 postmenopausal women with coronary disease. The primary predictor variable was a 4-state categorical depression variable based on the Burnam depression screen assessed at sequential visits. The outcome variable was self-rated overall health (excellent, very good, or good vs fair or poor).
  
  
  RESULTS
  After adjustment for age, comorbidities, prior self-rated health, and interim events, women with depression at both current and prior annual visits had a >5-fold increased odds of fair/poor self-rated health (odds ratio [OR] 5.1, 95% CI 3.8-6.8). New depression was associated with a >2-fold increased odds of fair/poor self-rated health (OR 2.6, 95% CI 2.0-3.4). Having a history of depression at the preceding annual visit but not at the current visit was associated with a slight increased odds of fair/poor self-rated health (OR 1.3, 95% CI 1.0-1.7). The magnitude of the impact of persistent or new depression was comparable to that of recent angina, myocardial infarction, angioplasty, heart failure, or bypass surgery.
  
  
  CONCLUSIONS
  Women with persistent or new depression are more likely to report fair/poor self-rated health. The magnitude of the impact of persistent or new depression is comparable to that of major cardiac events.
authors.affiliation: Division of General Internal Medicine, Department of Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611-2927, USA.
authors.forename: Bernice
authors.initials: B
authors.lastname: Ruo
authors.forename: Daniel
authors.initials: D
authors.lastname: Bertenthal
authors.forename: Saunak
authors.initials: S
authors.lastname: Sen
authors.forename: Vera
authors.initials: V
authors.lastname: Bittner
authors.forename: Christine C
authors.initials: CC
authors.lastname: Ireland
authors.forename: Mark A
authors.initials: MA
authors.lastname: Hlatky
mesh_terms: D000368:Aged; D003327:Coronary Disease / Q000150:complications / Q000523:psychology*; D003863:Depression / Q000150:complications*; D005260:Female; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D011446:Prospective Studies; D012307:Risk Factors; D012647:Self-Assessment