title: Depressive symptoms in persons with acute coronary syndrome: specific symptom scales and prognosis.
abstract: 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.
authors.affiliation: Department of Psychology, Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin 2, Ireland. fdoyle4@rcsi.ie
authors.forename: Frank
authors.initials: F
authors.lastname: Doyle
authors.forename: Ronán
authors.initials: R
authors.lastname: Conroy
authors.forename: Hannah
authors.initials: H
authors.lastname: McGee
authors.forename: Mary
authors.initials: M
authors.lastname: Delaney
mesh_terms: 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