Somatic/affective symptoms, but not cognitive/affective symptoms, of depression after acute coronary syndrome are associated with 12-month all-cause mortality

BACKGROUND: Symptom dimensions of post myocardial infarction (MI) depression may be differently related to prognosis. Somatic/affective symptoms appear to be associated with a worse cardiac outcome than cognitive/affective symptoms. We examined the relationship between depressive symptom dimensions following acute coronary syndrome (ACS) and both disease severity and all-cause mortality. METHODS: Patients (n=913) who had unstable angina pectoris or MI were recruited from 12 coronary care units between 1997 and 1999. Measurements included sociodemographic and clinical data and the Beck Depression Inventory (BDI). Endpoint was all-cause mortality at 12-month follow-up. RESULTS: Principal component analysis revealed two components, somatic/affective and cognitive/affective symptoms of depression. Somatic/affective symptoms of depression (odds ratio (OR): 1.49; 95% confidence interval (CI): 1.23-1.81; p<0.001) but not cognitive/affective symptoms (OR: 0.92; 95% CI: 0.75-1.12; p=0.40) were related to a higher Killip class. Fifty-one patients died during the follow-up period. When controlling for index event, history of MI, Killip class, diabetes, gender and age, there was a significant association between the somatic/affective component (OR: 1.92; 95% CI: 1.36-2.71; p<0.001) and mortality. The cognitive/affective component was not related to mortality (OR: 1.07; 95% CI: 0.75-1.52; p=0.73). LIMITATIONS: Time to death was not available. CONCLUSIONS: This study showed that only somatic/affective depressive symptoms were associated with disease severity and all-cause mortality in ACS patients. More research is needed to evaluate the differential associations of somatic/affective and cognitive/affective depressive symptoms with cardiac outcomes and the underlying mechanisms

Large-aperture deformable mirror correction of tiled-grating wavefront error

When tiling three gratings, with each individually exhibiting astigmatism and power due to holographic errors and coating stress, the resulting wavefront aberrations contain high-frequency components as well as the fundamental frequency, which is nearly three cycles across the aperture in the tiling direction. A deformable mirror (DM) that was designed to compensate for much slower errors (e.g., those arising from distortion in amplifier disks) is being used to compensate for this tiling-induced error. This investigation studies the effectiveness of compensating only the fundamental frequency of the tiled aberration, and shows that this provides a significant improvement that is adequate for a range of expected aberrations. Limitations of the DM correction technique are also studied

Somatic symptom overlap in Beck Depression Inventory-II scores following myocardial infarction

Background Depression measures that include somatic symptoms may inflate severity estimates among medically ill patients, including those with cardiovascular disease. Aims To evaluate whether people receiving in-patient treatment following acute myocardial infarction (AMI) had higher somatic symptom scores on the Beck Depression Inventory-II (BDI-II) than a non-medically ill control group matched on cognitive/affective scores. Method Somatic scores on the BDI-II were compared between 209 patients admitted to hospital following an AMI and 209 psychiatry out-patients matched on gender, age and cognitive/affective scores, and between 366 post-AMI patients and 366 undergraduate students matched on gender and cognitive/affective scores. Results Somatic symptoms accounted for 44.1% of total BDI-II score for the 209 post-AMI and psychiatry out-patient groups, 52.7% for the 366 post-AMI patients and 46.4% for the students. Post-AMI patients had somatic scores on average 1.1 points higher than the students (P < 0.001). Across groups, somatic scores accounted for approximately 70% of low total scores (BDI-II < 4) v. approximately 35% in patients with total BDI-II scores of 12 or more. Conclusions Our findings contradict assertions that self-report depressive symptom measures inflate severity scores in post-AMI patients. However, the preponderance of somatic symptoms at low score levels across groups suggests that BDI-II scores may include a small amount of somatic symptom variance not necessarily related to depression in post-AMI and non-medically ill respondents