title: Predicting mortality 12 years after an acute cardiac event: comparison between inhospital and 2-month assessment of depressive symptoms in women.
abstract: OBJECTIVE
  Research demonstrates that depression at the time of a cardiac event predicts early mortality. However, the best time for depression screening is unknown. We investigated the prognostic importance of inhospital and 2-month depressive symptoms in predicting 12-year mortality in female cardiac patients.
  
  
  METHODS
  A consecutive series of 170 women admitted to hospital after acute myocardial infarction or for coronary artery bypass graft surgery completed the Hospital Anxiety and Depression Scale inhospital and 2 months later. Hospital Anxiety and Depression Scale's depression subscale scores of 4 to 7 were classified as "mild" depressive symptoms and 8+ as "moderate/severe" depressive symptoms. Mortality was tracked through the Australian National Death Index and other sources.
  
  
  RESULTS
  : One hundred sixty-three (96%) of the 170 women were successfully tracked after 12 years. Of these women, 136 (83%) completed the depression subscale of the Hospital Anxiety and Depression Scale at both assessments and were included in the analyses. Over 12 years, 45 (33%) women died. Using logistic regression and controlling for age, disease severity, and diabetes, mild inhospital depression predicted mortality (P = .02), whereas moderate/severe inhospital depression did not (P = .14). At 2 months, moderate/severe depression predicted mortality (P = .05), whereas mild depression did not (P = .09). Half the patients (49%) changed depression class by the 2-month assessment. The death rate was highest (64%) in those whose mild inhospital depressive symptoms increased to moderate/severe and lowest (14%) in those whose moderate/severe inhospital symptoms remitted.
  
  
  CONCLUSIONS
  Mild inhospital depression and moderate/severe 2-month depression were predictive of 12-year deaths. The findings suggest a prognostic benefit in undertaking repeat depression screening 2 months after an acute cardiac event.
authors.affiliation: Heart Research Centre and Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia. barbara.murphy@heartresearchcentre.org
authors.forename: Barbara
authors.initials: B
authors.lastname: Murphy
authors.forename: Michelle
authors.initials: M
authors.lastname: Rogerson
authors.forename: Marian
authors.initials: M
authors.lastname: Worcester
authors.forename: Peter
authors.initials: P
authors.lastname: Elliott
authors.forename: Rosemary
authors.initials: R
authors.lastname: Higgins
authors.forename: Michael
authors.initials: M
authors.lastname: Le Grande
authors.forename: Alyna
authors.initials: A
authors.lastname: Turner
authors.forename: Alan
authors.initials: A
authors.lastname: Goble
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000401:mortality* / Q000523:psychology; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000523:psychology; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors