<p>Background: Self-reported depressive symptoms and clinical depression after myocardial infarction (MI) are both associated with poor cardiac prognosis. It is important to distinguish between the two when assessing cardiac prognosis, but few studies have done so. The present article evaluates the independent prognostic impact of self-reported depressive symptoms and clinical depression on cardiac outcomes after MI.</p><p>Methods: 2704 MI-patients were administered the Beck Depression Inventory (BDI) and underwent the Composite International Diagnostic Interview at 3 months post-MI. All-cause mortality, cardiac mortality and cardiovascular readmissions were evaluated up till 10 years post-MI (mean: 6 years), representing 16,783 persons-years of follow-up. Event-free survival was evaluated using Cox regression analysis.</p><p>Results: Analyses on mortality and cardiovascular readmissions included 2493 and 2434 patients respectively. Compared to patients scoring = 19 had age-and sex-adjusted HR's (95% CI) of 3.20 (2.16-4.74, p</p><p>Conclusions: After MI, self-reported depressive symptoms are a more accurate predictor of cardiac morbidity and mortality than clinical depression. This association is confounded largely by cardiac disease severity. (C) 2012 Elsevier Ireland Ltd. All rights reserved.</p>
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