Thombs Brett D, Ziegelstein Roy C, Stewart Donna E, Abbey Susan E, Parakh Kapil, Grace Sherry L
Department of Psychiatry, Sir Mortimer B. Davis-Jewish General Hospital and McGill University, Montreal, Quebec, Canada.
Am J Cardiol. 2008 Jan 1;101(1):15-9. doi: 10.1016/j.amjcard.2007.07.043. Epub 2007 Nov 26.
Previous research has focused on the relation between depression after an acute coronary syndrome (ACS) and subsequent cardiac morbidity and mortality. However, the relation between depression and quality of life during recovery remains unclear. We investigated whether symptoms of depression during hospitalization for ACS or the course of depressive symptoms after ACS predict physical health status 12 months after ACS, controlling for physical health status at the time of the ACS. This was a prospective study of 425 patients with ACS assessed with the Beck Depression Inventory (BDI) and Short Form 12 (SF-12) Health Survey during hospitalization and 12 months later. Linear regression was used to assess the relation between in-hospital BDI scores and BDI symptom trajectory after ACS with physical health status 12 months later, controlling for baseline physical health status, age, gender, Killip class, history of acute myocardial infarction, and cardiac diagnosis. Baseline BDI scores predicted 12-month physical health (p <0.001). Compared with nondepressed patients, only patients with persistent symptoms of depression were at risk for poorer physical health. Patients with newly developed depressive symptoms after ACS were at slightly increased risk for worsened physical health (p = 0.060), whereas patients with transient depressive symptoms were not at increased risk. In conclusion, these results underscore the importance of assessing depression at the time of ACS and on an ongoing basis.
以往的研究主要关注急性冠状动脉综合征（ACS）后抑郁与随后的心脏发病率和死亡率之间的关系。然而，抑郁与恢复期间生活质量之间的关系仍不明确。我们研究了ACS住院期间的抑郁症状或ACS后抑郁症状的病程是否能预测ACS后12个月的身体健康状况，并对ACS时的身体健康状况进行了控制。这是一项对425例ACS患者的前瞻性研究，在住院期间和12个月后分别用贝克抑郁量表（BDI）和简短健康调查量表12（SF-12）进行评估。采用线性回归分析评估住院期间BDI评分和ACS后BDI症状轨迹与12个月后的身体健康状况之间的关系，并对基线身体健康状况、年龄、性别、Killip分级、急性心肌梗死病史和心脏诊断进行控制。基线BDI评分可预测12个月后的身体健康状况（p<0.001）。与非抑郁患者相比，只有持续存在抑郁症状的患者身体健康状况较差。ACS后新出现抑郁症状的患者身体健康状况恶化的风险略有增加（p=0.060），而短暂性抑郁症状的患者风险未增加。总之，这些结果强调了在ACS时及持续评估抑郁的重要性。
