title: Depression and cardiac symptoms among AL amyloidosis patients: the mediating role of coping strategies.
abstract: BACKGROUND
  Amyloidosis is a rare disease group. AL amyloidosis represents the most common type of systemic amyloidosis and cardiac involvement determines prognosis. Although some studies have revealed that amyloidosis patients present high levels of depression, few data are available about depression-contributing factors. No investigations have been conducted about the coping strategies that AL amyloidosis patients use to face the disease and there is little research on patients with cardiac symptoms that are strongly related to the prognosis.
  
  
  OBJECTIVE
  to examine coping strategies (avoidance, social support seeking and problem-solving) as potential mediator in the relationship between cardiac symptom severity (independent variable) and depressive symptoms (dependent variable) in AL cardiologic patients.
  
  
  METHODS
  Thirty-four AL patients with cardiac-related symptoms were administered the Coping Strategy Indicator and the Centre for Epidemiological Study-Depression Scale. Clinical variables such as months since cardiac symptom onset and cardiac symptom severity were collected.
  
  
  RESULTS
  According to questionnaire normative values, all patients presented clinical depression. Moreover, out of the coping strategies, avoidance and social support seeking mediated the link between cardiac symptom severity and depressive symptoms. No mediational effect was found for problem-solving.
  
  
  CONCLUSIONS
  As cardiac symptoms have low severity, AL patients can avoid the disease. However, as cardiac symptoms proceed and interfere with daily activities, they can no longer ignore their signs thus perceiving the severity of their medical condition. This status makes individuals prone to seek less social support and thus to prefer social isolation. Results suggest the need for early psychological support on coping strategies for AL cardiologic patients.
authors.affiliation: a Faculty of Education , Free University of Bolzano , Bressanone , Italy .
authors.forename: Martina
authors.initials: M
authors.lastname: Smorti
authors.forename: Francesco
authors.initials: F
authors.lastname: Cappelli
authors.forename: Silvia
authors.initials: S
authors.lastname: Guarnieri
authors.forename: Franco
authors.initials: F
authors.lastname: Bergesio
authors.forename: Federico
authors.initials: F
authors.lastname: Perfetto
mesh_terms: D000223:Adaptation, Psychological / Q000502:physiology*; D000368:Aged; D000369:Aged, 80 and over; D000686:Amyloidosis / Q000150:complications / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D005260:Female; D006331:Heart Diseases / Q000209:etiology / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index