3 research outputs found
Symptoms of Depression, Anxiety, and Posttraumatic Stress among Patients with Cardiac Pacemakers
Despite being a prerequisite for tailoring specific therapeutic interventions, knowledge of
pattern and prevalence of clinically significant psychiatric symptomatology among patients with
cardiac pacemakers (PMs), especially of symptoms of posttraumatic stress, is limited. We studied
symptoms of depression, anxiety, and posttraumatic stress among PM patients (PM due to syncope or
presyncope) compared to participants of (i) a cardiac, (ii) a chronic disease, and (iii) a healthy control
group. Symptoms of depression, anxiety and posttraumatic stress were measured by validated
self-report scales at least 6 months after implantation of the PM (PM group; n = 38), percutaneous
coronary intervention (PCI; PCI control group; n = 23), and first dialysis (Dialysis control group;
n = 17). Blood donors constituted the Healthy control group (n = 42). Both PM, PCI, and dialysis
patients reported depressive symptoms above clinical cut-off more frequently than the healthy
controls (16.2, 26.1, 41.2, and 0%, respectively; p < 0.001). Self-report of symptoms of anxiety and
posttraumatic stress did not differ significantly across study groups. However, a non-negligible
proportion of PM patients reported on symptoms of posttraumatic stress of anticipated clinical
relevance. Identification and treatment of depression deserves attention in clinical routine in all three
patient populations. Further study of posttraumatic stress in PM patients seems advisable
The predictive value of depression in the years after heart transplantation for mortality during long-term follow-up
Objective
Current understanding of the prognostic impact of depression on mortality after heart transplantation (HTx) is limited. We examined whether depression after HTx is a predictor of mortality during extended follow-up. Subsequently, we explored whether different symptom dimensions of depression could be identified and whether they were differentially associated with mortality.
Methods
Survival analyses were performed in a sample of 141 HTx recipients assessed for depression, measured by self-report of depressive symptoms (Beck Depression Inventory – version 1A [BDI-1A]), at median 5.0 years after HTx, and followed thereafter for survival status for up to 18.6 years. We used uni- and multivariate Cox proportional hazard models to examine the association of clinically significant depression (BDI-1A total score ≥10), as well as the cognitive-affective and the somatic subscales of the BDI-1A (resulting from principal component analysis) with mortality. In the multivariate analyses, we adjusted for relevant sociodemographic and clinical variables.
Results
Clinically significant depression was a significant predictor of mortality (hazard ratio = 2.088; 95% confidence interval = 1.366–3.192; p = .001). Clinically significant depression also was an independent predictor of mortality in the multivariate analysis (hazard ratio = 1.982; 95% confidence interval = 1.220–3.217; p = .006). The somatic subscale, but not the cognitive-affective subscale, was significantly associated with increased mortality in univariate analyses, whereas neither of the two subscales was an independent predictor of mortality in the multivariate analysis.
Conclusions
Depression measured by self-report after HTx is associated with increased mortality during extended follow-up. Clinical utility and predictive validity of specific depression components require further study.acceptedVersio
The predictive value of depression in the years after heart transplantation for mortality during long-term follow-up
Objective
Current understanding of the prognostic impact of depression on mortality after heart transplantation (HTx) is limited. We examined whether depression after HTx is a predictor of mortality during extended follow-up. Subsequently, we explored whether different symptom dimensions of depression could be identified and whether they were differentially associated with mortality.
Methods
Survival analyses were performed in a sample of 141 HTx recipients assessed for depression, measured by self-report of depressive symptoms (Beck Depression Inventory – version 1A [BDI-1A]), at median 5.0 years after HTx, and followed thereafter for survival status for up to 18.6 years. We used uni- and multivariate Cox proportional hazard models to examine the association of clinically significant depression (BDI-1A total score ≥10), as well as the cognitive-affective and the somatic subscales of the BDI-1A (resulting from principal component analysis) with mortality. In the multivariate analyses, we adjusted for relevant sociodemographic and clinical variables.
Results
Clinically significant depression was a significant predictor of mortality (hazard ratio = 2.088; 95% confidence interval = 1.366–3.192; p = .001). Clinically significant depression also was an independent predictor of mortality in the multivariate analysis (hazard ratio = 1.982; 95% confidence interval = 1.220–3.217; p = .006). The somatic subscale, but not the cognitive-affective subscale, was significantly associated with increased mortality in univariate analyses, whereas neither of the two subscales was an independent predictor of mortality in the multivariate analysis.
Conclusions
Depression measured by self-report after HTx is associated with increased mortality during extended follow-up. Clinical utility and predictive validity of specific depression components require further study