Clinical Correlates of Depression following Myocardial Infarction

Abstract

Objective: Post-MI depression increases mortality, especially in the first 18 months after MI. Identifying patients at risk for post-MI depression is therefore important. In the present study we investigated possible correlates for post-MI depression on an a priori basis. Method: Based on the literature, four clinically easily attainable variables were selected as possible correlates for post-MI depression. These were prescription of benzodiazepines during acute hospitalization, cardiac complications during acute hospitalization, history of depression, and not being able to stop smoking within six months after MI. A consecutive cohort of 173 first-MI patients was screened with the SCL-90 depression scale and DSM-III-R citeria for major depression. Of this cohort 35 depressed patients were compared with 35 non-depressed post-MI patients, matched for gender, age, and severity of MI. Results: In univariate analyses, complications during hospitalisation (OR = 2.14; CI = 0.89–5.14), prescription of benzodiazepines (OR = 3.67; CI = 1.11–12.1), history of depression (OR = 3.0; CI = 0.87–10.4), and not being able to stop smoking (OR = 4.5; CI = 1.11–18.2) were clinical correlates for post-MI depression. Multivariate analyses showed that none of these variables were independent of the others in predicting depression. Conclusions: A number of easily measurable patient characteristics identify those MI-patients at risk of post-MI depression. Further investigations should focus on the predictive value of these factors in relation to post-MI depression.