Depressive symptoms in persons with acute coronary syndrome: specific symptom scales and prognosis.
OBJECTIVE
To determine which particular depressive symptom scales, derived from three scales, predicted poorer prognosis in persons with acute coronary syndrome (ACS).


METHODS
Hospitalized ACS patients (n=408) completed questionnaires (depression, vital exhaustion). Mokken scaling derived unidimensional scales. Major cardiac events (cardiac mortality, ACS, unplanned revascularization) were assessed at median 67 weeks post event.


RESULTS
Only depressive symptoms of fatigue-sadness predicted prognosis in univariate (hazard ratio [HR]=1.8, 95% CI 1.1-3.0, P=.025) and multivariate analysis (HR=1.8, 95% CI 1.1-2.9, P=.025). Symptoms of anhedonia (HR=1.6, 95% CI 0.9-2.8, P=.102) and depressive cognitions (HR=1.3, 95% CI 0.7-2.2, P=.402) did not.


CONCLUSIONS
Symptoms of fatigue-sadness, but not other symptoms, were associated with increased risk of major cardiac events. Depression should be considered as a multidimensional, rather than a unidimensional, entity when designing interventions.
Doyle
Frank
F
Department of Psychology, Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin 2, Ireland. fdoyle4@rcsi.ie
Conroy
Ronán
R
McGee
Hannah
H
Delaney
Mary
M
D054058:Acute Coronary Syndrome / Q000523:psychology*; D000368:Aged; D003863:Depression / Q000175:diagnosis* / Q000523:psychology; D005221:Fatigue / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012720:Severity of Illness Index; D012737:Sex Factors; D011795:Surveys and Questionnaires