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From the Department of Psychiatry, University of Adelaide, South Australia (G.S.); and Health Outcomes Unit, Strategic Planning and Population Health, Department of Human Services, Adelaide, South Australia (F.C., A.-L.H., N.G.).
Address correspondence and reprint requests to Dr. Geoff Schrader, University Department of Psychiatry, The Queen Elizabeth Hospital, 28 Woodville Road Woodville, SA 5011. E-mail: geoffrey.schrader{at}adelaide.edu.au
OBJECTIVE: Depression occurs comorbidly in patients hospitalized for a range of cardiac conditions and procedures. This study examines the fluctuations in depressive symptomatology from index hospitalization to 3 months after hospitalization and determines predictors of depression 3 months after hospital admission for a cardiac condition or procedure.
METHODS: Baseline clinical and demographic variables collected from a prospective study of the natural history of depression in 833 hospitalized cardiac patients were entered into a multinomial regression analysis.
RESULTS: Similar proportions of participants were found to have no, mild, or moderate to severe depression at baseline and at 3 months, although 35.8% of participants had moved from one depression level to another during that period. Baseline characteristics predicting depression at 3 months after hospitalization were: a mild or moderate to severe level of depressive symptoms at hospitalization; younger age; smoking; self-reported previous diagnosis of a cardiac condition; and self-reported history of depression, anxiety, or stress.
CONCLUSIONS: The five clinically accessible variables identified as predictors in this study may assist physicians in identification of cardiac patients who are at risk of persistent depression and who may require active intervention. Given that depression in cardiac patients is related to increased mortality and morbidity and that it is currently poorly diagnosed, these findings may have implications for preventing adverse outcomes.
Key Words: depression, • inpatients, • coronary heart disease, • predictors, • natural history, • multinomial regression model.
Abbreviations: CABG = coronary artery bypass graft;; CES-D = Center for Epidemiological Studies – Depression Scale;; CHF = congestive heart failure;; CI = confidence interval;; IDACC = Identifying Depression as a Comorbid Condition;; MI = myocardial infarction;; OR = odds ratio.
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