Somatic and sociodemographic predictors of depression outcome among depressed patients with coronary artery disease - a secondary analysis of the SPIRR-CAD study

Autor: Martina de Zwaan, Jana Jünger, Martin Hellmich, Karl-Heinz Ladwig, Hans-Christian Deter, Frank Vitinius, Matthias Michal, Katja Petrowski, Cora Weber, Steffen Escherich, Christoph Herrmann-Lingen, Frank Lambertus, Christian Albus, Joram Ronel
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
medicine.medical_specialty
lcsh:RC435-571
Comorbidity
Coronary Artery Disease
Logistic regression
Hospital Anxiety and Depression Scale
law.invention
Coronary artery disease
03 medical and health sciences
0302 clinical medicine
Percutaneous Coronary Intervention
Randomized controlled trial
law
Internal medicine
lcsh:Psychiatry
Outcome Assessment
Health Care
Medicine
Heart rate variability
Humans
030212 general & internal medicine
Myocardial infarction
Adverse effect
Depression (differential diagnoses)
Aged
business.industry
Depression
Social Support
Middle Aged
medicine.disease
3. Good health
030227 psychiatry
ddc
Psychiatry and Mental health
Medically Unexplained Symptoms
Treatment Outcome
Socioeconomic Factors
Mental Disorders
Coronary Heart Disease
Psychotherapy
Type D Personality
Female
business
Depression - mental disorders - coronary heart disease - psychotherapy - type D personality
Research Article
Zdroj: BMC Psychiatry, Vol 19, Iss 1, Pp 1-9 (2019)
BMC Psychiatry 19:57 (2019)
BMC Psychiatry
DOI: 10.1186/s12888-019-2026-6
Popis: Background Depressive symptoms are common in patients with coronary artery disease (CAD) and are associated with an unfavourable outcome. Establishing prognostic patient profiles prior to the beginning of mental health care may facilitate higher efficacy of targeted interventions. The aim of the current study was to identify sociodemographic and somatic predictors of depression outcome among depressed patients with CAD. Methods Based on the dataset of the multicentre SPIRR-CAD randomised controlled trial (n = 570 patients with CAD and ≥ 8 points on the Hospital Anxiety and Depression Scale (HADS)), 141 potential sociodemographic and somatic predictors of the change in the HADS-D depression score from baseline to 18-month-follow-up were derived in two different ways. We screened for univariable association with response, using either analysis of (co)variance or logistic regression, respectively, both adjusted for baseline HADS-D value and treatment group. To guard against overfitting, multivariable association was evaluated by a linear or binomial (generalised) linear model with lasso regularisation, a machine learning approach. Outcome measures were the change in continuous HADS-D depression scores, as well as three established binary criteria. The Charlson Comorbidity Index (CCI) was calculated to assess possible influences of comorbidities on our results and was also entered in our machine learning approach. Results Higher age (p = 0.002), unknown previous myocardial infarction (p = 0.013), and a higher heart rate variability during numeracy tests (p = .020) were univariably associated with a favourable depression outcome, whereas hyperuricemia (p ≤ 0.003), higher triglycerides (p = 0.014), NYHA class III (p ≤ 0.028), state after resuscitation (p ≤ 0.042), intake of thyroid hormones (p = 0.007), antidiabetic drugs (p = 0.015), analgesic drugs (p = 0.027), beta blockers (p = 0.035), uric acid drugs (p ≤ 0.039), and anticholinergic drugs (p = 0.045) were associated with an adverse effect on the HADS-D depression score. In all analyses, no significant differences between study arms could be found and physical comorbidities also had no significant influence on our results. Conclusion Our findings may contribute to identification of somatic and sociodemographic predictors of depression outcome in patients with CAD. The unexpected effects of specific medication require further clarification and further research is needed to establish a causal association between depression outcome and our predictors. Trial registration www.clinicaltrials.gov NCT00705965 (registered 27th of June, 2008). www.isrctn.com ISRCTN76240576 (registered 27th of March, 2008).
Databáze: OpenAIRE
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