Walters Paul, Barley Elizabeth A, Mann Anthony, Phillips Rachel, Tylee André
University Department of Mental Health, Dorset HealthCare University NHS Foundation Trust and Bournemouth University, Bournemouth, Dorset, United Kingdom.
Florence Nightingale School of Nursing and Midwifery, King's College London, London, United Kingdom.
PLoS One. 2014 Jun 12;9(6):e98342. doi: 10.1371/journal.pone.0098342. eCollection 2014.
An association between depression and coronary heart disease is now accepted but there has been little primary care research on this topic. The UPBEAT-UK studies are centred on a cohort of primary patients with coronary heart disease assessed every six months for up to four years. The aim of this research was to determine the prevalence and associations of depression in this cohort at baseline.
Participants with coronary heart disease were recruited from general practice registers and assessed for cardiac symptoms, depression, quality of life and social problems.
803 people participated. 42% had a documented history of myocardial infarction, 54% a diagnosis of ischaemic heart disease or angina. 44% still experienced chest pain. 7% had an ICD-10 defined depressive disorder. Factors independently associated with this diagnosis were problems living alone (OR 5.49, 95% CI 2.11-13.30), problems carrying out usual activities (OR 3.71, 95% CI 1.93-7.14), experiencing chest pain (OR 3.27, 95% CI 1.58-6.76), other pains or discomfort (OR 3.39, 95% CI 1.42-8.10), younger age (OR 0.95 per year 95% CI 0.92-0.98).
Problems living alone, chest pain and disability are important predictors of depression in this population.
抑郁症与冠心病之间的关联现已得到认可，但关于这一主题的初级保健研究却很少。英国UPBEAT研究以一组冠心病初级患者为中心，每六个月对其进行评估，为期四年。这项研究的目的是确定该队列在基线时抑郁症的患病率及相关因素。
从全科医疗登记册中招募冠心病患者，并对其心脏症状、抑郁症、生活质量和社会问题进行评估。
803人参与了研究。42%的人有心肌梗死病史记录，54%的人被诊断为缺血性心脏病或心绞痛。44%的人仍有胸痛症状。7%的人患有国际疾病分类第10版（ICD - 10）定义的抑郁症。与该诊断独立相关的因素包括独居问题（比值比[OR]5.49，95%置信区间[CI]2.11 - 13.30）、进行日常活动存在问题（OR 3.71，95% CI 1.93 - 7.14）、经历胸痛（OR 3.27，95% CI 1.58 - 6.76）、其他疼痛或不适（OR 3.39，95% CI 1.42 - 8.10）、年龄较轻（每年OR 0.95，95% CI 0.92 - 0.98）。
独居问题、胸痛和残疾是该人群抑郁症的重要预测因素。
