Burden, screening, and treatment of depressive and anxious symptoms among women referred to cardiac rehabilitation: a prospective study.
Cardiovascular disease (CVD) is one of the leading causes of morbidity and mortality among women. Women with CVD experience a greater burden of psychosocial distress than men, and practice guidelines promote screening in cardiac patients, especially women. The objectives herein were to describe the burden of psychosocial distress, extent of screening, forms of treatment, and whether receipt of treatment was related to psychosocial distress symptom severity at follow-up, among women.



Within a multi-center trial of women randomized to cardiac rehabilitation models, consenting participants were asked to complete surveys upon consent and 6 months later. Clinical data were extracted from charts. This study presents a secondary analysis of the surveys, including investigator-generated items assessing screening and treatment, the Beck Depression Inventory-II, the Hospital Anxiety and Depression Scale, and Patient Health Questionnaire-2.



Of the 128 (67.0%) participants with valid baseline and follow-up survey results, 48 (40.3%) self-reported that they recalled being screened, and of these, 10 (21.3%) recalled discussing the results with a health care professional. Fifty-six (43.8%) retained participants had elevated symptoms of psychosocial distress at baseline, of which 25 (44.6%) were receiving treatment. Regression analyses showed that treatment of psychosocial distress was not significantly associated with follow-up depressive symptoms, but was significantly associated with greater follow-up anxiety.



Findings reiterate the great burden of psychosocial distress among women with CVD. Less than half of patients with elevated symptoms were treated, and the treatment approaches appeared to insufficiently achieve symptom relief.
School of Kinesiology and Health Science, York University, 368 Bethune College-4700 Keele Street, Toronto, Ontario, M3J 1P3, Canada.|University Health Network, Toronto, Ontario, Canada.
Megan C
MC
Hurley
Hamilton Health Sciences Centre, Hamilton, Ontario, Canada.
Heather M
HM
Arthur
University Health Network, Toronto, Ontario, Canada.
Caroline
C
Chessex
University Health Network, Toronto, Ontario, Canada.
Paul
P
Oh
Public Health Department, Qatar University, Doha, Qatar.
Karam
K
Turk-Adawi
School of Kinesiology and Health Science, York University, 368 Bethune College-4700 Keele Street, Toronto, Ontario, M3J 1P3, Canada. sgrace@yorku.ca.|University Health Network, Toronto, Ontario, Canada. sgrace@yorku.ca.
Sherry L
SL
Grace
D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D001007:Anxiety / Q000523:psychology / Q000628:therapy; D000072038:Cardiac Rehabilitation / Q000523:psychology; D017281:Cost of Illness; D003863:Depression / Q000523:psychology / Q000628:therapy; D008403:Mass Screening / Q000379:methods / Q000592:standards; D009864:Ontario; D011446:Prospective Studies; D013315:Stress, Psychological / Q000150:complications / Q000209:etiology; D011795:Surveys and Questionnaires; D016032:Randomized Controlled Trials as Topic
Anxiety; Cardiac rehabilitation; Depression; Screening; Women