10779/rcsi.10773980.v1 Frank Doyle Frank Doyle Ronán Conroy Ronán Conroy Hannah McGee Hannah McGee Mary Delaney Mary Delaney Depressive symptoms in persons with acute coronary syndrome: specific symptom scales and prognosis Royal College of Surgeons in Ireland 2019 Depression Acute coronary syndrome Mokken scaling Item response theory Prognosis Myocardial infarction Psychology and Cognitive Sciences not elsewhere classified 2019-11-22 15:43:30 Journal contribution https://repository.rcsi.com/articles/journal_contribution/Depressive_symptoms_in_persons_with_acute_coronary_syndrome_specific_symptom_scales_and_prognosis/10773980 <p>Objective To determine which particular depressive symptom scales, derived from three scales, predicted poorer prognosis in persons with acute coronary syndrome (ACS). Methods Hospitalised ACS patients (n=408) completed questionnaires (depression, vital exhaustion). Mokken scaling derived unidimensional scales. Major cardiac events (cardiac mortality, ACS, unplanned revascularisation) were assessed at median 67 weeks post-event. Results Only depressive symptoms of fatigue-sadness predicted prognosis in univariate (hazard ratio [HR]=1.8, 95% CI 1.1–3.0, p=0.025) and multivariate analysis (HR=1.8, 95% CI 1.1–2.9, p=0.025). Symptoms of anhedonia (HR=1.6, 95% CI 0.9–2.8, p=0.102) and depressive cognitions (HR=1.3, 95% CI 0.7–2.2, p=0.402) did not. Conclusion Symptoms of fatigue-sadness, but not other symptoms, were associated with increased risk of major cardiac events. Depression should be considered as a multidimensional, rather than a unidimensional, entity when designing interventions.</p>