Söderman Eva, Lisspers Jan, Sundin Orjan
Department of Social Sciences, MidSweden University, Ostersund, Sweden.
J Rehabil Med. 2007 May;39(5):412-7. doi: 10.2340/16501977-0064.
The aims of this study were to investigate the time-course of depressive mood in patients with coronary artery disease during a secondary prevention rehabilitation program, and to analyse how different pre-treatment levels of depressive mood during a treatment phase were related to the degree of lifestyle change at 36 months follow-up.
The study group comprised 109 of the original 183 consecutive coronary artery disease patients (91 male and 18 female) of whom 48 recently had experienced an acute myocardial infarction, 36 had been treated with coronary bypass surgery, 13 with percutaneous transluminal coronary angioplasty, and 12 had angina pectoris that had not been invasively treated. The subjects were divided into 3 subgroups based on their pre-treatment level of depressive mood.
Depressive mood was assessed at baseline, after 4 weeks and 12 months, using the depression subscale of the Hospital Anxiety and Depression scale. Lifestyle changes analysed included diet, smoking, relaxation (stress management) and exercise.
Overall depressive mood ratings were significantly lower, both at the 4-week and 12-month assessments, compared with baseline, with the greatest improvements in patients with higher Hospital Anxiety and Depression measured depression. Original levels of depressive mood were not found to influence change of lifestyle habits during a 36-month follow-up period.
Depressive mood might not be an obstacle to lifestyle changes when participating in a behaviourally oriented rehabilitation program including exercise-training, which might be a component important for improved depressive mood.
本研究旨在调查冠心病患者在二级预防康复计划期间抑郁情绪的时间进程，并分析治疗阶段不同的治疗前抑郁情绪水平与36个月随访时生活方式改变程度之间的关系。
研究组由最初连续纳入的183例冠心病患者中的109例组成（91例男性，18例女性），其中48例近期经历过急性心肌梗死，36例接受过冠状动脉搭桥手术，13例接受过经皮冠状动脉腔内血管成形术，12例有未接受侵入性治疗的心绞痛。根据治疗前抑郁情绪水平将受试者分为3个亚组。
使用医院焦虑抑郁量表的抑郁分量表在基线、4周和12个月后评估抑郁情绪。分析的生活方式改变包括饮食、吸烟、放松（压力管理）和运动。
与基线相比，在4周和12个月评估时，总体抑郁情绪评分均显著降低，医院焦虑抑郁量表测量的抑郁程度较高的患者改善最大。在36个月的随访期内，未发现初始抑郁情绪水平会影响生活方式习惯的改变。
参与包括运动训练在内的行为导向康复计划时，抑郁情绪可能不是生活方式改变的障碍，而运动训练可能是改善抑郁情绪的重要组成部分。
