title: Levels of anxiety and depression as predictors of mortality following myocardial infarction: A 5-year follow-up.
abstract: BACKGROUND
  Post-myocardial infarction (MI) depression is a highly prevalent disorder, affecting nearly 18% of all MI patients, and it is a major predictor of disability in the year post-MI. We sought to expand this analysis by: comparing case-level anxiety, depression, and comorbid anxiety and depression as predictors of long term mortality during a 5-year follow-up period after MI; and investigating the role of potential modifying and confounding factors.
  
  
  METHODS
  A total of 285 patients were screened on average 6 days after their MI and a 5-year survival rate was ascertained. The Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI) were completed by patients hospitalized for MI. In addition we tested the BDI × STAI interaction effect.
  
  
  RESULTS
  During the 5 years of follow-up, cardiac mortality was assessed in 274 of 285 eligible patients. Of the 274 patients whose survival data were available, 91 (33.2%) died. At entry, BDI score of 192 (67.4%) patients was ≥ 10 and 145 (50.9%) patients had STAI score ≥ 40. Anxiety was not associated with mortality, whereas depression significantly predicted death, but this association was attenuated to non-significance with full adjustment with disease severity and confounders.
  
  
  CONCLUSIONS
  Depression following MI does not predict longer-term survival with full adjustment.
authors.affiliation: Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran. swt_f@yahoo.com.
authors.forename: Seyed Hamzeh
authors.initials: SH
authors.lastname: Hosseini
authors.forename: Ali
authors.initials: A
authors.lastname: Ghaemian
authors.forename: Elaheh
authors.initials: E
authors.lastname: Mehdizadeh
authors.forename: Haleh
authors.initials: H
authors.lastname: Ashraf
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000175:diagnosis / Q000401:mortality* / Q000523:psychology; D015897:Comorbidity; D015986:Confounding Factors, Epidemiologic; D003863:Depression / Q000175:diagnosis / Q000401:mortality* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality* / Q000523:psychology / Q000628:therapy; D011379:Prognosis; D016016:Proportional Hazards Models; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult