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Increased risk of mortality after an acute coronary syndrome among patients with comorbid anxiety and depression

Published online by Cambridge University Press:  16 April 2020

B.D. Thombs ,
R.C. Ziegelstein ,
D.E. Stewart ,
S.E. Abbey  and
S.L. Grace
B.D. Thombs
Affiliation:
Department of Psychiatry, Sir Mortimer B. Davis - Jewish General Hospital and McGill University, Montreal, QC, Canada
R.C. Ziegelstein
Affiliation:
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
D.E. Stewart
Affiliation:
Women's Health Program, University Health Network, Toronto, ON, Canada Faculty of Medicine, University of Toronto, Toronto, ON, Canada
S.E. Abbey
Affiliation:
Women's Health Program, University Health Network, Toronto, ON, Canada Faculty of Medicine, University of Toronto, Toronto, ON, Canada
S.L. Grace
Affiliation:
Women's Health Program, University Health Network, Toronto, ON, Canada Faculty of Medicine, University of Toronto, Toronto, ON, Canada School of Kinesiology and Health Science, York University, Toronto, ON, Canada

Abstract

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Background and aims:

Symptoms of at least mild depression (Beck Depression Inventory [BDI] >/= 10), are associated with mortality in acute coronary syndrome (ACS) patients. The BDI, however, is largely a measure of general distress and does not discriminate well between anxiety and depression. We examined the independent contributions of anxiety and depression, as classified by the self-report version of the PRIME-MD, to mortality 1-year post-ACS.

Methods:

Prospective observational study of 765 ACS patients assessed with the PRIME-MD and BDI during hospitalization and followed for 1 year. Logistic regression to predict 1-year mortality based on in-hospital assessments.

Results:

Based on the PRIME-MD in-hospital, 99 patients (12.9%) screened positive for panic disorder, 58 (7.6%) for general anxiety disorder, and 174 (22.7%) for depression. Of 266 patients (34.8%) with a BDI >/= 10, 100 (37.6%) had no PRIME-MD diagnosis, 70 (26.3%) had only depression, 23 (8.6%) had only an anxiety disorder, and 73 (27.4%) had depression and an anxiety disorder. Controlling for age, gender, Killip class, prior myocardial infarction (MI), and cardiac diagnosis (MI vs. unstable angina) and compared to patients with no PRIME-MD diagnosis, the odds ratio of mortality was 1.75 (95% confidence interval [CI] 0.66 to 4.64, p = .26) for patients with depression alone, 2.97 (CI 0.93 to 9.55, p = .07) for patients with anxiety alone, and 4.43 (CI 1.72 to 11.40, p < .01) for patients with both depression and anxiety.

Conclusions:

When assessing the psychosocial status of ACS patients, both depression and anxiety should be considered.

Type
Poster Session 2: Anxiety, Stress Related, Impulse and Somatoform Disorders
Information
European Psychiatry , Volume 22 , Issue S1: 15th AEP Congress - Abstract book - 15th AEP Congress , March 2007 , pp. S290
Copyright
Copyright © European Psychiatric Association 2007
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