University of Massachusetts Medical School, Worcester, USA.
Int J Psychiatry Med. 2011;42(2):195-210. doi: 10.2190/PM.42.2.g.
To identify symptom profiles of depression and anxiety in patients with an acute coronary syndrome (ACS), to examine changes in symptom profiles over time, and finally, to examine the effects of age and sex on patients' symptom profiles.
One hundred ACS patients with mild to severe symptoms of depression and/or anxiety at 1 month post-hospital discharge were enrolled in a randomized trial of cognitive behavioral therapy. Latent class and latent transition analyses were used to identify symptom profiles and describe change over the time in profile membership.
A two-class solution was selected to describe depression and anxiety symptom profiles. Class I (76% of patients at baseline) was labeled "depression and some anxiety symptoms." Class II (24% of patients at baseline) was labeled "anxiety and some depression symptoms." Approximately 25% of patients in the treatment condition transitioned from the depression and some anxiety symptoms class to the anxiety and some depression symptoms class at follow-up compared to 10% of patients in the control condition at follow-up; nearly 50% of patients in the control condition showed worsening of symptoms as compared to 28% in the treatment condition. Results suggested age differences in the probabilities of transitioning between the classes; older patients were more likely to continue having depression and some anxiety symptoms at the time of follow-up.
Identifying symptom profiles of depression and anxiety in patients with an ACS may improve diagnostic practices and help to design tailored interventions.
确定急性冠状动脉综合征(ACS)患者抑郁和焦虑的症状特征,考察症状特征随时间的变化情况,并最终检验年龄和性别对患者症状特征的影响。
100 名 ACS 患者在出院后 1 个月内出现轻度至重度抑郁和/或焦虑症状,他们被纳入认知行为治疗的随机试验。采用潜在类别和潜在转变分析来识别症状特征,并描述特征成员随时间的变化。
选择了一个两类别解决方案来描述抑郁和焦虑症状特征。第 I 类(基线时 76%的患者)被标记为“抑郁和一些焦虑症状”。第 II 类(基线时 24%的患者)被标记为“焦虑和一些抑郁症状”。与对照组相比,治疗组中有约 25%的患者在随访时从抑郁和一些焦虑症状类别转变为焦虑和一些抑郁症状类别,而对照组只有 10%的患者在随访时转变;与对照组相比,约 50%的对照组患者症状恶化,而治疗组只有 28%的患者恶化。结果表明,年龄差异影响类别之间转变的可能性;年龄较大的患者在随访时更有可能继续出现抑郁和一些焦虑症状。
确定 ACS 患者的抑郁和焦虑症状特征可以改善诊断实践,并有助于设计量身定制的干预措施。