title: Are vital exhaustion and depression independent risk factors for cardiovascular disease morbidity?
abstract: The aim of this study was to examine the concurrent effects of vital exhaustion and depression on the development of cardiovascular disease (CVD) morbidity.
  
  
  
  The sample of this representative, 4-year longitudinal study comprised 2,725 participants (43.56% male, Mage = 58.39 years, SDage = 14.39 years). Individuals being treated for hypertension (n = 277) and cardio- and/or cerebrovascular incidents (n = 131) for the first time during the follow-up period were compared with participants never treated for CVD (n = 2,317). Joint principal component analysis was conducted on the items of the vital exhaustion (shortened Maastricht Questionnaire) and depression (shortened Beck Depression Inventory) measures simultaneously resulting in 3 components representing depression, vital exhaustion, and sleep difficulties. The role of these 3 components in predicting the incidence of CVD morbidity was examined using logistic regression-controlling for traditional risk factors such as sex, age, education, body mass index, smoking, alcohol use, and physical inactivity.
  
  
  
  In the multivariate analyses, vital exhaustion (OR = 1.20, CI = 1.03-1.39, p = .021) and sleep-related problem (OR = 1.16, CI = 1.00-1.33, p = .044) scores proved to be independent predictors of treatment initiation for hypertension, while sleep-related difficulties predicted CVD event incidence (OR = 1.27, CI = 1.06-1.52, p = .009). However, depressive symptomatology factor scores were not associated with either cardiovascular outcome in the regression analyses.
  
  
  
  Vital exhaustion and depressive symptomatology showed a different pattern in their relationship with CVD incidence, with vital exhaustion being the more robust predictor. These results suggest that the 2 constructs are not identical and that vital exhaustion deserves consideration when planning and implementing interventions to reduce CVD risk. (PsycINFO Database Record
authors.affiliation: Institute of Behavioural Sciences, Semmelweis University.
authors.forename: Piroska
authors.initials: P
authors.lastname: Balog
authors.affiliation: Department of Psychiatry and Neuropsychology, Maastricht University.
authors.forename: Paul R J
authors.initials: PRJ
authors.lastname: Falger
authors.affiliation: Counselling Center, Budapest Metropolitan University.
authors.forename: Gábor
authors.initials: G
authors.lastname: Szabó
authors.affiliation: Institute of Psychology, University of Szeged.
authors.forename: Beatrix
authors.initials: B
authors.lastname: Rafael
authors.affiliation: Gottsegen György National Institute of Cardiology.
authors.forename: Andrea
authors.initials: A
authors.lastname: Székely
authors.affiliation: Research and Academics Division, Waypoint Centre for Mental Health Care.
authors.forename: Barna
authors.identifier: 0000-0002-0861-8978
authors.initials: B
authors.lastname: Konkolÿ Thege
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000523:psychology*; D003863:Depression / Q000150:complications* / Q000453:epidemiology; D005221:Fatigue / Q000150:complications* / Q000523:psychology; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors