Martens Elisabeth J, Denollet Johan, Pedersen Susanne S, Scherders Mark, Griez Eric, Widdershoven Jos, Szabó Balázs, Bonnier Hans, Appels Ad
Department of Medical Psychology, Center of Research on Psychology in Somatic diseases, Tilburg University, The Netherlands.
J Affect Disord. 2006 Aug;94(1-3):231-7. doi: 10.1016/j.jad.2006.04.023. Epub 2006 Jun 2.
Depression has been associated with adverse clinical events in myocardial infarction (MI) patients, but many questions about the nature of post-MI depression remain unanswered. We examined whether depressive cognitions characteristic of depression in psychiatric patients are also present in post-MI patients with major depression (MD).
Non-depressed (n=40) and depressed (n=40) post-MI patients, and psychiatric outpatients (n=40) treated for clinical depression, matched on age and sex, were interviewed using a structured clinical interview to diagnose DSM-IV MD. All patients also completed the Beck Depression Inventory (BDI) and the Beck Cognition Checklist-Depression subscale (CCL-D).
Mean levels of depressive cognitions were considerably higher in depressed psychiatric patients compared with depressed post-MI patients (34.9 versus 28.0; p=.013), and higher in depressed post-MI patients compared with non-depressed post-MI patients (28.0 versus 17.8; p<.0001), adjusted for age, sex, educational level, and marital status. Younger age (p=.024), absence of a partner (p=.016) and depressed psychiatric status (p=.016) were independently associated with depressive cognitions. Psychiatric patients also had higher mean levels of depressive symptoms as compared to depressed post-MI patients (25.1 versus 17.8; p=.001).
This study is based on a cross-sectional design.
The symptom presentation of MD in post-MI patients is both quantitatively and qualitatively different from that seen in psychiatric patients, suggesting that depressive symptoms in post-MI patients differ in content from those in psychiatric patients. These findings could have important consequences for the design and contents of therapeutic programs for treating depression in post-MI patients.
抑郁症与心肌梗死（MI）患者的不良临床事件相关，但关于心肌梗死后抑郁症的本质仍有许多问题未得到解答。我们研究了精神病患者抑郁症特有的抑郁认知是否也存在于患有重度抑郁症（MD）的心肌梗死后患者中。
对年龄和性别相匹配的非抑郁（n = 40）和抑郁（n = 40）的心肌梗死后患者以及因临床抑郁症接受治疗的精神科门诊患者（n = 40）进行结构化临床访谈，以诊断DSM-IV重度抑郁症。所有患者还完成了贝克抑郁量表（BDI）和贝克认知清单 - 抑郁分量表（CCL-D）。
与抑郁的心肌梗死后患者相比，抑郁的精神科患者的抑郁认知平均水平显著更高（34.9对28.0；p = 0.013），并且在调整年龄、性别、教育水平和婚姻状况后，抑郁的心肌梗死后患者的抑郁认知平均水平高于非抑郁的心肌梗死后患者（28.0对17.8；p < 0.0001）。年龄较小（p = 0.024）、没有伴侣（p = 0.016）和抑郁的精神状态（p = 0.016）与抑郁认知独立相关。与抑郁的心肌梗死后患者相比，精神科患者的抑郁症状平均水平也更高（25.1对17.8；p = 0.001）。
本研究基于横断面设计。
心肌梗死后患者重度抑郁症的症状表现在数量和质量上均与精神科患者不同，这表明心肌梗死后患者的抑郁症状在内容上与精神科患者不同。这些发现可能对心肌梗死后患者抑郁症治疗方案的设计和内容产生重要影响。
