title: Depressive vulnerabilities predict depression status and trajectories of depression over 1 year in persons with acute coronary syndrome.
abstract: OBJECTIVE
  Depression is prevalent in patients hospitalized with acute coronary syndrome (ACS). We determined whether theoretical vulnerabilities for depression (interpersonal life events, reinforcing events, cognitive distortions, Type D personality) predicted depression, or depression trajectories, post-hospitalization.
  
  
  METHODS
  We followed 375 ACS patients who completed depression scales during hospital admission and at least once during three follow-up intervals over 1 year (949 observations). Questionnaires assessing vulnerabilities were completed at baseline. Logistic regression for panel/longitudinal data predicted depression status during follow-up. Latent class analysis determined depression trajectories. Multinomial logistic regression modeled the relationship between vulnerabilities and trajectories.
  
  
  RESULTS
  Vulnerabilities predicted depression status over time in univariate and multivariate analysis, even when controlling for baseline depression. Proportions in each depression trajectory category were as follows: persistent (15%), subthreshold (37%), never depressed (48%). Vulnerabilities independently predicted each of these trajectories, with effect sizes significantly highest for the persistent depression group.
  
  
  CONCLUSIONS
  Self-reported vulnerabilities - stressful life events, reduced reinforcing events, cognitive distortions, personality - measured during hospitalization can identify those at risk for depression post-ACS and especially those with persistent depressive episodes. Interventions should focus on these vulnerabilities.
authors: Division of Population Health Sciences (Psychology), Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin 2, Ireland. fdoyle4@csi.ie
authors: Frank
authors: F
authors: Doyle
authors: Hannah
authors: H
authors: McGee
authors: Mary
authors: M
authors: Delaney
authors: Nicola
authors: N
authors: Motterlini
authors: Ronán
authors: R
authors: Conroy