Association of baseline anxiety with depression persistence at 6 months in patients with acute cardiac illness.
OBJECTIVE
To assess the association of baseline anxiety with depression persistence and change in depressive symptoms 6 months after cardiac hospitalization.


METHODS
Data were analyzed from 137 depressed patients hospitalized on inpatient cardiac units for acute coronary syndrome, decompensated heart failure, or arrhythmia and who were enrolled in a randomized trial of collaborative care depression management. Subjects' demographic, medical, and psychiatric information at baseline was compiled. Measures of health-related quality of life, cardiac symptoms, and psychiatric symptoms, including the Hospital Anxiety and Depression Scale-anxiety subscale (HADS-A) for anxiety, were obtained at baseline and serially during a 6-month follow-up period. The association between baseline HADS-A score and depression persistence (<50% reduction in depressive symptoms on the Patient Health Questionnaire-9) at 6 months was assessed by multivariate logistic regression accounting for the effects of multiple relevant medical and psychological covariates. The association between baseline HADS-A score and improvement in depressive symptoms (Patient Health Questionnaire-9) from baseline at 6 months was assessed by linear regression accounting for the same covariates.


RESULTS
Baseline HADS-A score was independently associated with depression persistence at 6 months (odds ratio = 1.11, 95% confidence interval = 1.01-1.22, p = .03). Likewise, higher baseline HADS-A score was associated with less improvement in depressive symptoms at 6 months (β = -0.34, p = .01).


CONCLUSIONS
Among a cohort of depressed cardiac patients, higher baseline anxiety score was linked with lesser improvement in depressive symptoms and increased likelihood of depression persistence at 6 months, independent of multiple relevant covariates.


BACKGROUND
clinicaltrials.gov Identifier: NCT00847132.
Massachusetts General Hospital, Warren 605, 55 Fruit St, Boston, MA 02114, USA. ccelano@partners.org
Christopher M
CM
Celano
Carol A
CA
Mastromauro
Emma C
EC
Lenihan
James L
JL
Januzzi
Bruce L
BL
Rollman
Jeff C
JC
Huffman
D000208:Acute Disease; D001007:Anxiety / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D003625:Data Collection; D003863:Depression / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D011788:Quality of Life; D012044:Regression Analysis; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome