1
|
Miao X, Chen Y, Qiu X, Wang R. Construction and Validation of a Nomogram Predicting Depression Risk in Patients with Acute Coronary Syndrome Undergoing Coronary Stenting: A Prospective Cohort Study. J Cardiovasc Dev Dis 2023; 10:385. [PMID: 37754813 PMCID: PMC10532347 DOI: 10.3390/jcdd10090385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/21/2023] [Accepted: 09/04/2023] [Indexed: 09/28/2023] Open
Abstract
PURPOSE To construct and validate a nomogram for predicting depression after acute coronary stent implantation for risk assessment. METHODS This study included 150 patients with acute coronary syndrome (ACS) who underwent stent implantation. Univariate analysis was performed to identify the predictors of postoperative depression among the 24 factors. Subsequently, multivariate logistic regression was performed to incorporate the significant predictors into the prediction model. The model was developed using the "rms" software package in R software, and internal validation was performed using the bootstrap method. RESULTS Of the 150 patients, 82 developed depressive symptoms after coronary stent implantation, resulting in an incidence of depression of 54.7%. Univariate analysis showed that sleep duration ≥7 h, baseline GAD-7 score, baseline PHQ-9 score, and postoperative GAD-7 score were associated with the occurrence of depression after stenting in ACS patients (all p < 0.05). Multivariate logistic regression analysis revealed that major life events in the past year (OR = 2.783,95%CI: 1.121-6.907, p = 0.027), GAD-7 score after operation (OR = 1.165, 95% CI: 1.275-2.097, p = 0.000), and baseline PHQ-9 score (OR = 3.221, 95%CI: 2.065-5.023, p = 0.000) were significant independent risk factors for ACS patients after stent implantation. Based on these results, a predictive nomogram was constructed. The model demonstrated good prediction ability, with an AUC of 0.857 (95% CI = 0.799-0.916). The correction curve showed a good correlation between the predicted results and the actual results (Brier score = 0.15). The decision curve analysis and prediction model curve had clinical practical value in the threshold probability range of 7 to 94%. CONCLUSIONS This nomogram can help to predict the incidence of depression and has good clinical application value. This trial is registered with ChiCTR2300071408.
Collapse
Affiliation(s)
- Xing Miao
- Department of Cardiology, Fujian Provincial Hospital, Fuzhou 350001, China;
- Department of Cardiology, Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350001, China
| | - Yongli Chen
- South Branch of Cardiology Department, Fujian Provincial Hospital, Fuzhou 350028, China;
- Department of Cardiology, Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350001, China
| | - Xiaoxia Qiu
- Department of Cardiology, Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350001, China
| | - Rehua Wang
- Department of Cardiology, Fujian Provincial Hospital, Fuzhou 350001, China;
- Department of Cardiology, Shengli Clinical Medical College of Fujian Medical University, Fuzhou 350001, China
| |
Collapse
|
2
|
Importance of Depressive Symptoms in Patients With Coronary Heart Disease - Review Article. Curr Probl Cardiol 2023; 48:101646. [PMID: 36773947 DOI: 10.1016/j.cpcardiol.2023.101646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 02/04/2023] [Indexed: 02/12/2023]
Abstract
Patients with myocardial infarction (MI) have both major depression as well as depressive symptoms. Therefore, due to the high prevalence of depression in post-MI patients, an assessment of its prognostic importance was put on the agenda. Patients after ACS frequently report fatigue, sleep problems, and sadness. Evaluation of these symptoms is very important because it should be clarified whether these symptoms are related only to the main disease or they indicate the presence of concomitant depression. Given a high predictive value of somatic-affective symptoms, it is recommended to assess them in post-MI patients. Further treatment of somatic and cognitive-affective symptoms of depression will improve the quality of life of patients with acute coronary events.
Collapse
|
3
|
Ciharova M, Cígler H, Dostálová V, Šivicová G, Bezdicek O. Beck depression inventory, second edition, Czech version: demographic correlates, factor structure and comparison with foreign data. Int J Psychiatry Clin Pract 2020; 24:371-379. [PMID: 32552177 DOI: 10.1080/13651501.2020.1775854] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE We aimed to examine whether demographic characteristics (i.e., sex, age and education) correlate with total scores of the Czech version of the Beck Depression Inventory (BDI-II), understand the factorial structure of this scale, compare our results with findings of studies conducted in other countries and provide preliminary normative data for use in clinical practice. METHODS Data of 450 participants were analysed using correlation analysis, non-parametric tests and confirmatory factor analysis (CFA). RESULTS Women, and participants with lower education, tended to score higher than men, and participants with higher education. There was no significant relationship between age and total scores. CFA confirmed two factors: cognitive-affective and somatic. Czech participants scored lower than participants in other studies. Preliminary normative data are presented in the form of percentile values for the whole sample and stratified according to gender and education level. CONCLUSIONS We recommend the usage of the BDI-II total score while taking into account also the cognitive-affective and somatic factor subscores. The comparison of our results with other foreign findings shows the need for the development of locally specific normative values for self-reported depression scales. KEY POINTS Women scored higher in the BDI-II than men. Participants with lower education scored higher in the BDI-II than participants with higher education. CFA confirmed two factors: cognitive-affective and somatic. Preliminary normative data for the Czech version of the BDI-II are stratified according to gender and education.
Collapse
Affiliation(s)
- Marketa Ciharova
- Diamant Neuropsychology Laboratory, Department of Neurology and Centre of Clinical Neuroscience, 1st Faculty of Medicine, General University Hospital in Prague, Charles University, Prague, Czech Republic.,Section Clinical Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hynek Cígler
- Department of Psychology & Institute for Research on Children, Youth, and Family, Faculty of Social Studies, Masaryk University, Brno, Czech Republic
| | - Veronika Dostálová
- Diamant Neuropsychology Laboratory, Department of Neurology and Centre of Clinical Neuroscience, 1st Faculty of Medicine, General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - Gabriela Šivicová
- Department of Psychology, Faculty of Arts, Charles University, Prague, Czech Republic
| | - Ondrej Bezdicek
- Diamant Neuropsychology Laboratory, Department of Neurology and Centre of Clinical Neuroscience, 1st Faculty of Medicine, General University Hospital in Prague, Charles University, Prague, Czech Republic.,Prague College of Psychosocial Studies, Prague, Czech Republic.,National Institute of Mental Health, Klecany, Czech Republic
| |
Collapse
|
4
|
Stein LK, Kornspun A, Erdman J, Dhamoon MS. Readmissions for Depression and Suicide Attempt following Stroke and Myocardial Infarction. Cerebrovasc Dis Extra 2020; 10:94-104. [PMID: 32854098 PMCID: PMC7548911 DOI: 10.1159/000509454] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 06/16/2020] [Indexed: 12/16/2022] Open
Abstract
Background and Purpose Rates of depression after ischemic stroke (IS) and myocardial infarction (MI) are significantly higher than in the general population and associated with morbidity and mortality. There is a lack of nationally representative data comparing depression and suicide attempt (SA) after these distinct ischemic vascular events. Methods The 2013 Nationwide Readmissions Database contains >14 million US admissions for all payers and the uninsured. Using International Classification of Disease, 9th Revision, Clinical Modification Codes, we identified index admission with IS (n = 434,495) or MI (n = 539,550) and readmission for depression or SA. We calculated weighted frequencies of readmission. We performed adjusted Cox regression to calculate hazard ratio (HR) for readmission for depression and SA up to 1 year following IS versus MI. Analyses were stratified by discharge home versus elsewhere. Results Weighted depression readmission rates were higher at 30, 60, and 90 days in patients with IS versus MI (0.04%, 0.09%, 0.12% vs. 0.03%, 0.05%, 0.07%, respectively). There was no significant difference in SA readmissions between groups. The adjusted HR for readmission due to depression was 1.49 for IS versus MI (95% CI 1.25–1.79, p < 0.0001). History of depression (HR 3.70 [3.07–4.46]), alcoholism (2.04 [1.34–3.09]), and smoking (1.38 [1.15–1.64]) were associated with increased risk of depression readmission. Age >70 years (0.46 [0.37–0.56]) and discharge home (0.69 [0.57–0.83]) were associated with reduced hazards of readmission due to depression. Conclusions IS was associated with greater hazard of readmission due to depression compared to MI. Patients with a history of depression, smoking, and alcoholism were more likely to be readmitted with depression, while advanced age and discharge home were protective. It is unclear to what extent differences in type of ischemic tissue damage and disability contribute, and further investigation is warranted.
Collapse
Affiliation(s)
- Laura K Stein
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA,
| | - Alana Kornspun
- Department of Medicine, University of North Carolina Hospitals, Chapel Hill, North Carolina, USA
| | - John Erdman
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Mandip S Dhamoon
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| |
Collapse
|
5
|
Gu XH, He CJ, Shen L, Han B. Association Between Depression and Outcomes in Chinese Patients With Myocardial Infarction and Nonobstructive Coronary Arteries. J Am Heart Assoc 2020; 8:e011180. [PMID: 30803294 PMCID: PMC6474919 DOI: 10.1161/jaha.118.011180] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background Myocardial infarction with nonobstructive coronary arteries ( MINOCA ) occurs in ≈10% of all patients with myocardial infarction. Studies on effects of depression on MINOCA outcomes are lacking. Therefore, the aim of this study was to examine the association of depression with clinical outcomes in Chinese patients with MINOCA . Methods and Results We conducted a prospective cohort study of 633 participants with MINOCA and followed up for 3 years. End points were defined as all-cause mortality and cardiovascular events. Diagnosis of depression was ascertained using the psychiatric interview based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). During the follow-up period, all-cause death occurred in 93 individuals and cardiovascular events developed in 170 individuals. Kaplan-Meier curves showed a significant association of depression with all-cause mortality (log-rank P<0.001) and cardiovascular events (log-rank P<0.001). Multiple Cox regression identified the new diagnosis of depression as an independent prognostic factor for all-cause mortality as well as cardiovascular events (adjusted hazard ratio, 7.250; 95% CI, 4.735-11.100; P<0.001; and hazard ratio, 3.411; 95% CI , 2.490-4.674; P<0.001, respectively). Conclusions The new diagnosis of depression at the time of myocardial infarction is associated with increased risk of adverse clinical outcomes in patients with MINOCA.
Collapse
Affiliation(s)
- Xiao-Hong Gu
- 1 Department of Infectious Diseases and Department of Nursing First Affiliated Hospital of Jiaxing University Jiaxing Zhejiang China
| | - Chao-Jie He
- 2 Department of Cardiology First Affiliated Hospital of Jiaxing University Jiaxing Zhejiang China
| | - Liang Shen
- 2 Department of Cardiology First Affiliated Hospital of Jiaxing University Jiaxing Zhejiang China
| | - Bin Han
- 3 Department of Nephrology First Affiliated Hospital of Jiaxing University Jiaxing Zhejiang China
| |
Collapse
|
6
|
Faro A, Pereira CR. Factor structure and gender invariance of the Beck Depression Inventory - second edition (BDI-II) in a community-dwelling sample of adults. Health Psychol Behav Med 2020; 8:16-31. [PMID: 34040860 PMCID: PMC8130720 DOI: 10.1080/21642850.2020.1715222] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective: The main purpose of this study was to investigate the factor structure of the Beck Depression Inventory – Second Edition (BDI-II) in a sample of adults. Specifically, we evaluated the BDI-II based on confirmatory factor analysis of different measurement models, and compared the optimal factor structure of the BDI-II by gender using measurement invariance analysis. Method: A cross-sectional survey with 717 community-dwelling adults was conducted. The Brazilian Portuguese version of the BDI-II was administered. Seven different models (one-, two-, three-factor models and their bifactor structures) were tested through CFA. CFA and multigroup analysis were executed with the software MPLUS (Weighted Least Squares Estimator – WLSMV). Results: Four bifactor models reached acceptable fit indices. A bifactor model with two specific factors (Cognitive–Affective, and Somatic-Affective) provided the best fit to the data. The multigroup analysis of this model demonstrated invariance by gender. Conclusions: Our findings support the use of the total BDI-II score to identify depressive symptoms, including gender comparisons. Since a bifactor structure fit the data better, the scores of the specific factors should not be used as the first choice, or at least should be used with caution. The analysis of the severity of depression, based on a total score, seems to be the most appropriate option.
Collapse
Affiliation(s)
- André Faro
- Department of Psychology, Federal University of Sergipe, UFS, São Cristóvão, Sergipe, Brazil
| | - Cicero R Pereira
- Department of Psychology, Federal University of Paraiba, UFPB, João Pessoa, Paraíba, Brazil
| |
Collapse
|
7
|
Harding KA, Pushpanathan ME, Whitworth SR, Nanthakumar S, Bucks RS, Skinner TC. Depression prevalence in Type 2 diabetes is not related to diabetes-depression symptom overlap but is related to symptom dimensions within patient self-report measures: a meta-analysis. Diabet Med 2019; 36:1600-1611. [PMID: 31532013 DOI: 10.1111/dme.14139] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/16/2019] [Indexed: 01/24/2023]
Abstract
AIM Depression is common in Type 2 diabetes, yet rates vary. Overlap between symptoms of depression and diabetes may account for this variability in depression prevalence rates. We examined to what extent depression prevalence was a function of the proportion of depression-diabetes symptom overlap (items within symptom dimensions) and sample characteristics. METHODS Electronic and hand searching of published and unpublished works identified 147 eligible papers. Of 3656 screened, 147 studies (149 samples, N = 17-229 047, mean sample age 25.4-82.8 years, with 152 prevalence estimates), using 24 validated depression questionnaires were selected. Sample size, publication type, sample type, gender, age, BMI, HbA1c , depression questionnaire and prevalence rates were extracted. RESULTS Prevalence rates ranged from 1.8% to 88% (mean = 28.30%) and were higher in younger samples, samples with higher mean HbA1c and clinic samples. Diabetes-depression symptom overlap did not affect prevalence. A higher proportion of anhedonia, cognition, cognitive, negative affect and sleep disturbance symptoms, and a lower proportion of somatic symptoms were consistently associated with higher depression prevalence. CONCLUSIONS The lack of an overall effect of diabetes-depression symptom overlap might suggest that assessment of depression in Type 2 diabetes is generally not confounded by co-occuring symptoms. However, questionnaires with proportionally more or fewer items measuring other symptom categories were associated with higher estimates of depression prevalence. Depression measures that focus on the cardinal symptoms of depression (e.g. negative affect and cognition), limiting symptoms associated with increasing diabetes symptomatology (e.g. sleep disturbance, cognitive) may most accurately diagnose depression.
Collapse
Affiliation(s)
- K A Harding
- VA Puget Sound Healthcare System, Seattle, WA, USA
| | - M E Pushpanathan
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - S R Whitworth
- Australian Government Department of Health, Canberra, Australia
| | - S Nanthakumar
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - R S Bucks
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - T C Skinner
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
8
|
A comprehensive analysis of the factor structure of the Beck Depression Inventory-II in a sample of outpatients with adjustment disorder and depressive episode. Ir J Psychol Med 2019; 35:53-61. [PMID: 30115209 DOI: 10.1017/ipm.2017.52] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Despite being commonly used in research and clinical practice, the evidence regarding the factor structure of the Beck Depression Inventory-II (BDI-II) remains equivocal and this has implications on how the scale scores should be aggregated. Researchers continue to debate whether the BDI-II is best viewed as a unidimensional scale, or whether specific subscales have utility. The present study sought to test a comprehensive range of competing factor analytic models of the BDI-II, including traditional non-hierarchical multidimensional models and confirmatory bifactor models. METHOD Participants (n=370) were clinical outpatients diagnosed with either depressive episode or adjustment disorder. Confirmatory factor analysis and confirmatory bifactor modelling were used to test 15 competing models. The unidimensionality of the best fitting model was assessed using three strength indices (explained common variance, percentage of uncontaminated correlations and ω hierarchical). RESULTS Overall, bifactor solutions provided superior fit than both unidimensional and non-hierarchical multidimensional models. The best fitting model consisted of a general depression factor and three specific factors: cognitive, somatic and affective. High factor loadings and strength indices for the general depression factor supported the view that the BDI-II measures a single latent construct. CONCLUSIONS The BDI-II should primarily be viewed as a unidimensional scale, and should be scored as such. Although it is not recommended that scores on individual subscales are used in isolation, they may prove useful in clinical assessment and/or treatment planning if used in conjunction with total scores.
Collapse
|
9
|
Depaoli S, Tiemensma J, Felt JM. Assessment of health surveys: fitting a multidimensional graded response model. PSYCHOL HEALTH MED 2019; 23:13-31. [PMID: 29544349 DOI: 10.1080/13548506.2018.1447136] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The multidimensional graded response model, an item response theory (IRT) model, can be used to improve the assessment of surveys, even when sample sizes are restricted. Typically, health-based survey development utilizes classical statistical techniques (e.g. reliability and factor analysis). In a review of four prominent journals within the field of Health Psychology, we found that IRT-based models were used in less than 10% of the studies examining scale development or assessment. However, implementing IRT-based methods can provide more details about individual survey items, which is useful when determining the final item content of surveys. An example using a quality of life survey for Cushing's syndrome (CushingQoL) highlights the main components for implementing the multidimensional graded response model. Patients with Cushing's syndrome (n = 397) completed the CushingQoL. Results from the multidimensional graded response model supported a 2-subscale scoring process for the survey. All items were deemed as worthy contributors to the survey. The graded response model can accommodate unidimensional or multidimensional scales, be used with relatively lower sample sizes, and is implemented in free software (example code provided in online Appendix). Use of this model can help to improve the quality of health-based scales being developed within the Health Sciences.
Collapse
Affiliation(s)
- Sarah Depaoli
- a Psychological Sciences , University of California, Merced , Merced , CA , USA
| | - Jitske Tiemensma
- a Psychological Sciences , University of California, Merced , Merced , CA , USA
| | - John M Felt
- a Psychological Sciences , University of California, Merced , Merced , CA , USA
| |
Collapse
|
10
|
The effect of exercise therapy on depressive and anxious symptoms in patients with ischemic heart disease: A systematic review. J Psychosom Res 2018; 105:80-91. [PMID: 29332638 DOI: 10.1016/j.jpsychores.2017.11.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 11/13/2017] [Accepted: 11/29/2017] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Depressive and anxiety symptoms are associated with Ischemic Heart Disease (IHD). Exercise interventions might improve both depressive and anxiety symptoms, but an overview of the evidence is lacking. Therefore, we systematically reviewed the existing literature on the effectiveness of exercise therapy to reduce depression and anxiety symptoms specifically in patients with IHD. METHODS MEDLINE, EMBASE, PsycINFO and the Cochrane Central Register of Controlled Trials were searched until January 2016. The effectiveness of exercise was assessed within two groups: a) patients selected for study with severe depression or anxiety; and b) studies that did not exclusively targeted patients with increased levels of depression or anxiety. Secondary outcomes were mortality, cardiac events, re-hospitalizations and cardiovascular risk factors. RESULTS We included fourteen studies. Clinical and methodological heterogeneity precluded meta-analysis. Three studies specifically included patients with high levels of depression or anxiety and eleven studies selected patients with unclear levels of depression or anxiety. Some RCTs showed that exercise was effective in lowering severe depressive symptoms (short and long term follow-up), but for the group with unclear depressive symptoms the results were non-conclusive. In the group with elevated anxiety symptoms, exercise had a positive effect on the short term follow-up. In the group with unclear anxiety symptoms the results were inconsistent (short and long term follow-up). No differences were found regarding the secondary outcomes. CONCLUSIONS There is a general paucity of data on the effect of exercise, precluding firm conclusions about the effectiveness of exercise for depressive and anxiety symptoms in IHD patients.
Collapse
|
11
|
Jayawickreme N, Verkuilen J, Jayawickreme E, Acosta K, Foa EB. Measuring Depression in a Non-Western War-Affected Displaced Population: Measurement Equivalence of the Beck Depression Inventory. Front Psychol 2017; 8:1670. [PMID: 29018389 PMCID: PMC5622946 DOI: 10.3389/fpsyg.2017.01670] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 09/11/2017] [Indexed: 11/25/2022] Open
Abstract
Depression is commonly seen in survivors of conflict and disaster across the world. There is a dearth of research on the validity of commonly used measures of depression in these populations. Measurements of depression that are used in multiple contexts need to meet measurement equivalence, i.e., the instrument measures the same construct in the same manner across different groups. The Beck Depression Inventory (BDI) was administered to female trauma survivors in the United States (n = 268) and female survivors of war in Sri Lanka (n = 149). Three metrics of measurement equivalence—structural, metric, and scalar—were examined. Two- and three-factor structures of the BDI that have been identified in other populations did not provide a good fit for our data. However, a bifactor model revealed a similar general distress dimension across populations, but dissimilar secondary dimensions or subfactors. The Sri Lankan subfactor comprised of predominantly somatic symptoms and the United States subfactor comprised of cognitive and somatic symptoms. While intercepts of individual BDI items differed, their differences seem to be offsetting. Total BDI scores across these two populations are roughly comparable, although caution is recommended when interpreting them. Making comparisons on subscales is not recommended.
Collapse
Affiliation(s)
- Nuwan Jayawickreme
- Department of Psychology, Manhattan College, New York City, NY, United States
| | - Jay Verkuilen
- Department of Educational Psychology, City University of New York, New York City, NY, United States
| | - Eranda Jayawickreme
- Department of Psychology, Wake Forest University, Winston-Salem, NC, United States
| | - Kaylaliz Acosta
- Department of Psychology, Manhattan College, New York City, NY, United States
| | - Edna B Foa
- Department of Psychiatry, Center for the Treatment and Study of Anxiety, University of Pennsylvania, Philadelphia, PA, United States
| |
Collapse
|
12
|
Changing depressive symptoms following percutaneous coronary intervention, clustering and effect on adherence - The THORESCI study. J Affect Disord 2016; 204:146-53. [PMID: 27344624 DOI: 10.1016/j.jad.2016.06.050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 06/15/2016] [Accepted: 06/15/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND Depressive symptom dimensions may have a differential effect on cardiac prognosis. It is yet unknown whether and how depressive symptoms change together over time and how this may affect disease progression. We examined the clustering of changing depressive symptoms over the first 6 months after percutaneous coronary intervention (PCI), and examined the influence of the change profile on the predictive value of depression for treatment adherence at 6 months post-PCI. METHODS PCI patients (N=219, age: 62±15, 20% women) reported on depressive symptoms (PHQ-9, BDI; 30 symptoms) and adherence (MOS-GAS) at 1 and 6 months post-PCI. Principal component analysis (PCA) was performed on the individual symptom change scores. Multivariable linear regression examined the role of change profiles in predicting general treatment adherence, while adjusting for demographic and clinical characteristics. RESULTS Four change-factors emerged from PCA. One somatic-affective change-factor (10 symptoms), two cognitive-affective change-factors (6 general cognitive-affective and 7 severe cognitive symptoms) and one mixed factor were identified. We extracted 5 symptom change profiles. Linear regression showed the moderating role of the change profiles. In patients reporting a net increase in depressive symptoms, higher cognitive affective symptoms (β=-.46, p=.001) and higher somatic-affective symptoms (β=-.29; p=.044) were associated with worse general adherence. DISCUSSION Four distinct depressive symptom change-factors were identified that moderated the association of somatic-affective and cognitive-affective depressive symptom levels with general treatment adherence. This is of clinical importance as not only current symptoms, but also symptom change over the preceding months may be important to consider in screening and risk prediction.
Collapse
|