title: Prevalence and predictors of depressive symptoms and wellbeing during and up to nine years after outpatient cardiac rehabilitation.
abstract: OBJECTIVE
  Depression is an important independent prognostic variable in cardiac patients. The prevalence and predictors of depressive symptoms up to nine years after cardiac rehabilitation were studied.
  
  
  METHODS
  Follow-up questionnaires were sent to 2199 patients who had completed a 12-week exercise-based outpatient cardiac rehabilitation (OCR) programme between June 1999 and March 2006. Medical outcome, general wellbeing, and depressive symptoms were assessed, the latter by using two screening questions according to Arrol. Patients with incomplete data due to language problems, lack of compliance and non-response were excluded.
  
  
  RESULTS
  Complete data for analysis was available for 710 patients. The median follow up period was 46 months (Interquartile range (IQR) 22-71, min. 6 months). At follow-up, 132 patients (19%) indicated low wellbeing, whereas 81 (11%) were having depressive symptoms. Multivariate analyses revealed impaired quality of life (p <0.001), diabetes (p = 0.013) and low exercise capacity after OCR (p = 0.003) to be independent predictors of low wellbeing at follow-up. Persistent smoking (p = 0.045) as well as negative mood (p = 0.022) at the end of OCR were independent predictors of depressive symptoms at follow-up.
  
  
  CONCLUSIONS
  In a selected patient population a mean of four years after OCR, persistent smoking, diabetes, low exercise capacity and impaired quality of life at the end of OCR were independent long term predictors of low wellbeing and depressive symptoms, rather than specific cardiac variables. This highlights the need for close cooperation between cardiovascular and psychological specialists in cardiac rehabilitation.
authors.affiliation: Division of Cardiology, University Hospital, CH.
authors.forename: O
authors.initials: O
authors.lastname: Koçer
authors.forename: M
authors.initials: M
authors.lastname: Wachter
authors.forename: M
authors.initials: M
authors.lastname: Zellweger
authors.forename: S
authors.initials: S
authors.lastname: Piazzalonga
authors.forename: A
authors.initials: A
authors.lastname: Hoffmann
mesh_terms: D000339:Affect; D000368:Aged; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D003920:Diabetes Mellitus / Q000523:psychology; D005081:Exercise Therapy / Q000523:psychology*; D017079:Exercise Tolerance; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006331:Heart Diseases / Q000523:psychology* / Q000534:rehabilitation*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology; D012307:Risk Factors; D012907:Smoking / Q000523:psychology; D011795:Surveys and Questionnaires