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>