Depression predicts failure to complete phase-II cardiac rehabilitation.
Reduced adherence to medical treatment regimens may help to explain the higher risk of mortality among depressed cardiac patients. Participation in cardiac rehabilitation is a highly recommended part of the medical treatment regimen for cardiac patients. This study examined if elevated depressive symptomology, as measured by the Beck Depression Inventory (BDI), predicted failure to complete a 12-week phase II cardiac rehabilitation program for 600 patients. Logistic regression analysis showed that patients with elevated levels of depressive symptomology (BDI scores > or = 10) were 2.2 times less likely to complete cardiac rehabilitation compared to patients without depression (BDI < 10), after controlling for age, gender, body mass index, and employment. Somatic symptoms predicted non-completion due to medical reasons, whereas younger age predicted failure to complete cardiac rehabilitation due to non-medical reasons. Given the difficulty of reducing mortality by treating depression directly, interventions targeting behavior change to improve medical treatment adherence might be an effective complementary strategy.
Casey
Elizabeth
E
Department of Psychology, Kent State University, P.O. Box 5190, Kent, OH 44242, USA.
Hughes
Joel W
JW
Waechter
Donna
D
Josephson
Richard
R
Rosneck
James
J
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D019090:Case Management; D015897:Comorbidity; D003325:Coronary Care Units / Q000706:statistics & numerical data; D003327:Coronary Disease / Q000401:mortality / Q000534:rehabilitation; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology / Q000401:mortality / Q000534:rehabilitation*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010352:Patient Dropouts / Q000523:psychology / Q000706:statistics & numerical data*; D010555:Personality Inventory / Q000706:statistics & numerical data; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors