Department of Psychology, Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin 2, Ireland.
J Psychosom Res. 2010 Feb;68(2):121-30. doi: 10.1016/j.jpsychores.2009.07.013.
To determine which particular depressive symptom scales, derived from three scales, predicted poorer prognosis in persons with acute coronary syndrome (ACS).
Hospitalized ACS patients (n=408) completed questionnaires (depression, vital exhaustion). Mokken scaling derived unidimensional scales. Major cardiac events (cardiac mortality, ACS, unplanned revascularization) were assessed at median 67 weeks post event.
Only depressive symptoms of fatigue-sadness predicted prognosis in univariate (hazard ratio [HR]=1.8, 95% CI 1.1-3.0, P=.025) and multivariate analysis (HR=1.8, 95% CI 1.1-2.9, P=.025). Symptoms of anhedonia (HR=1.6, 95% CI 0.9-2.8, P=.102) and depressive cognitions (HR=1.3, 95% CI 0.7-2.2, P=.402) did not.
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.
确定源于三个量表的哪些特定抑郁症状量表可预测急性冠状动脉综合征（ACS）患者的预后较差。
住院 ACS 患者（n=408）完成了问卷调查（抑郁、生命耗竭）。Mokken 量表得出了单维量表。主要心脏事件（心脏死亡率、ACS、非计划性血运重建）在事件后中位数 67 周进行评估。
只有疲劳-悲伤的抑郁症状在单变量（危险比[HR]=1.8，95%置信区间 1.1-3.0，P=.025）和多变量分析（HR=1.8，95%置信区间 1.1-2.9，P=.025）中预测预后。快感缺失症状（HR=1.6，95%置信区间 0.9-2.8，P=.102）和抑郁认知（HR=1.3，95%置信区间 0.7-2.2，P=.402）无此作用。
疲劳-悲伤的症状而非其他症状与主要心脏事件的风险增加相关。在设计干预措施时，应将抑郁视为一种多维而非单维实体。
