Grace Sherry L, Leung Yvonne W, Stewart Donna E
York University and University Health Network Women's Health Program, York University.
Psychosomatics. 2008 May-Jun;49(3):199-207. doi: 10.1176/appi.psy.49.3.199.
Depression has been implicated in the occurrence of recurrent coronary events and cardiac or all-cause mortality in acute coronary syndrome (ACS) patients.
The authors describe the frequency and type of antidepressant use and its correlates 18 months after ACS hospital discharge.
A sample of 661 ACS inpatients, recruited from three hospitals, completed a sociodemographic survey and the Hospital Anxiety and Depression Scale (HADS), and clinical data were extracted from charts. A mailed survey 9 months and 18 months post-discharge assessed self-reported antidepressant use, and the HADS was re-administered.
Approximately 9% of participants reported antidepressant use both 9 and 18 months post-hospitalization, with 77% concordance in usage over time. Participants most frequently reported using selective serotonin reuptake inhibitors and least often tricyclics. Logistic regression revealed that antidepressant users were more likely to be anxious and have more comorbidity, and were less likely to work full-time, whereas number of medications, age, and marital status were not related.
Patients with comorbid physical and mental conditions who are unemployed may be more likely to receive an antidepressant because of greater depression symptoms or greater exposure to healthcare providers, which increases the potential for symptom recognition and treatment.
抑郁症与急性冠状动脉综合征（ACS）患者复发性冠状动脉事件及心脏或全因死亡率的发生有关。
作者描述了ACS患者出院18个月后抗抑郁药的使用频率、类型及其相关因素。
从三家医院招募了661名ACS住院患者作为样本，他们完成了一项社会人口统计学调查和医院焦虑抑郁量表（HADS），并从病历中提取临床数据。出院后9个月和18个月进行的邮寄调查评估了自我报告的抗抑郁药使用情况，并再次进行了HADS测试。
约9%的参与者报告在住院后9个月和18个月均使用了抗抑郁药，随着时间推移，用药一致性为77%。参与者最常报告使用选择性5-羟色胺再摄取抑制剂，最不常使用三环类药物。逻辑回归显示，使用抗抑郁药的患者更可能焦虑且合并症更多，全职工作的可能性更小，而用药数量、年龄和婚姻状况则无关联。
患有身心合并症且失业的患者可能因抑郁症状更严重或与医疗服务提供者接触更多而更有可能接受抗抑郁药治疗，这增加了症状识别和治疗的可能性。
