Self-rated health among women with coronary disease: depression is as important as recent cardiovascular events.

Autor: Ruo B; Division of General Internal Medicine, Department of Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611-2927, USA., Bertenthal D, Sen S, Bittner V, Ireland CC, Hlatky MA
Jazyk: angličtina
Zdroj: American heart journal [Am Heart J] 2006 Nov; Vol. 152 (5), pp. 921.e1-7.
DOI: 10.1016/j.ahj.2006.01.012
Abstrakt: Background: Prior studies have shown an association between depression and self-rated health among patients with coronary disease. However, the magnitude of the effect of depression on self-rated health compared with that of major clinical events is unknown. Our main objective was to clarify the association between depression and self-rated health using longitudinal data.
Methods: We performed a prospective cohort study of 2675 postmenopausal women with coronary disease. The primary predictor variable was a 4-state categorical depression variable based on the Burnam depression screen assessed at sequential visits. The outcome variable was self-rated overall health (excellent, very good, or good vs fair or poor).
Results: After adjustment for age, comorbidities, prior self-rated health, and interim events, women with depression at both current and prior annual visits had a >5-fold increased odds of fair/poor self-rated health (odds ratio [OR] 5.1, 95% CI 3.8-6.8). New depression was associated with a >2-fold increased odds of fair/poor self-rated health (OR 2.6, 95% CI 2.0-3.4). Having a history of depression at the preceding annual visit but not at the current visit was associated with a slight increased odds of fair/poor self-rated health (OR 1.3, 95% CI 1.0-1.7). The magnitude of the impact of persistent or new depression was comparable to that of recent angina, myocardial infarction, angioplasty, heart failure, or bypass surgery.
Conclusions: Women with persistent or new depression are more likely to report fair/poor self-rated health. The magnitude of the impact of persistent or new depression is comparable to that of major cardiac events.
Databáze: MEDLINE
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