Massachusetts General Hospital, Warren 605, 55 Fruit St, Boston, MA 02114, USA.
Psychosom Med. 2012 Jan;74(1):93-9. doi: 10.1097/PSY.0b013e31823d38bc. Epub 2011 Dec 30.
To assess the association of baseline anxiety with depression persistence and change in depressive symptoms 6 months after cardiac hospitalization.
Data were analyzed from 137 depressed patients hospitalized on inpatient cardiac units for acute coronary syndrome, decompensated heart failure, or arrhythmia and who were enrolled in a randomized trial of collaborative care depression management. Subjects' demographic, medical, and psychiatric information at baseline was compiled. Measures of health-related quality of life, cardiac symptoms, and psychiatric symptoms, including the Hospital Anxiety and Depression Scale-anxiety subscale (HADS-A) for anxiety, were obtained at baseline and serially during a 6-month follow-up period. The association between baseline HADS-A score and depression persistence (<50% reduction in depressive symptoms on the Patient Health Questionnaire-9) at 6 months was assessed by multivariate logistic regression accounting for the effects of multiple relevant medical and psychological covariates. The association between baseline HADS-A score and improvement in depressive symptoms (Patient Health Questionnaire-9) from baseline at 6 months was assessed by linear regression accounting for the same covariates.
Baseline HADS-A score was independently associated with depression persistence at 6 months (odds ratio = 1.11, 95% confidence interval = 1.01-1.22, p = .03). Likewise, higher baseline HADS-A score was associated with less improvement in depressive symptoms at 6 months (β = -0.34, p = .01).
Among a cohort of depressed cardiac patients, higher baseline anxiety score was linked with lesser improvement in depressive symptoms and increased likelihood of depression persistence at 6 months, independent of multiple relevant covariates.
clinicaltrials.gov Identifier: NCT00847132.
评估基线焦虑与心脏住院 6 个月后抑郁持续和抑郁症状变化的相关性。
对因急性冠状动脉综合征、失代偿性心力衰竭或心律失常住院接受心脏内科治疗的 137 例抑郁患者进行分析，这些患者参与了协作式护理抑郁管理的随机试验。对患者基线时的人口统计学、医学和精神病学信息进行了编译。在基线和 6 个月的随访期间，连续测量健康相关生活质量、心脏症状和精神症状，包括医院焦虑抑郁量表-焦虑子量表（HADS-A）。采用多变量逻辑回归评估基线 HADS-A 评分与 6 个月时抑郁持续（患者健康问卷-9 的抑郁症状减少<50%）的相关性，同时考虑了多种相关医学和心理协变量的影响。采用线性回归评估基线 HADS-A 评分与 6 个月时（患者健康问卷-9）抑郁症状改善的相关性，同时考虑了相同的协变量。
基线 HADS-A 评分与 6 个月时的抑郁持续独立相关（优势比=1.11，95%置信区间=1.01-1.22，p=0.03）。同样，基线 HADS-A 评分越高，6 个月时抑郁症状改善越少（β=-0.34，p=0.01）。
在一组抑郁性心脏病患者中，较高的基线焦虑评分与抑郁症状改善较少、6 个月时抑郁持续的可能性增加有关，与多个相关协变量无关。
clinicaltrials.gov 标识符：NCT00847132。
