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Symptom Dimensions of Depression Following Myocardial Infarction and Their Relationship With Somatic Health Status and Cardiovascular Prognosis
Abstract
OBJECTIVE: The reporting of depressive symptoms following myocardial infarction may be confounded by complaints originating from the myocardial infarction. Therefore, it is difficult to estimate the effects of post-myocardial infarction depression and its treatment on cardiovascular prognosis. The authors' goal was to study the relationship between depressive symptom dimensions following myocardial infarction and both somatic health status and prospective cardiovascular prognosis. METHOD: In two studies of myocardial infarction patients (N=494 and 1,972), the Beck Depression Inventory was used to determine the dimensional structure of depressive symptoms following myocardial infarction. Three symptom dimensions-somatic/affective, cognitive/affective, and appetitive-were compared with baseline left ventricular ejection fraction, Charlson comorbidity index, Killip class, and previous myocardial infarction. The relationship between depressive symptom dimensions and prospective cardiovascular mortality and cardiac-related readmissions was also examined (mean follow-up duration=2.5 years). RESULTS: Somatic/affective symptoms were associated with poor health status (left ventricular ejection fraction, Charlson comorbidity index, Killip class, and previous myocardial infarction) and predicted cardiovascular mortality and cardiac events. Cognitive/affective symptoms were only marginally associated with somatic health status and not with cardiovascular death and cardiac events. Appetitive symptoms were related to somatic health status but did not predict cardiovascular death or cardiac events. CONCLUSIONS: Somatic/affective depressive symptoms following myocardial infarction were confounded by somatic health status yet were prospectively associated with cardiac prognosis even after somatic health status was controlled. Cognitive/affective depressive symptoms were only marginally related to health status and not to cardiac prognosis. These findings suggest that treatment of depression following myocardial infarction might improve cardiovascular prognosis when it reduces somatic/affective symptoms.
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“Indeed, several recently published papers even suggest that (in patients with myocardial infarction or with chronic heart failure) the so-called somatic/affective symptoms of depression are more predictive of overall mortality than the cognitive/affective symptoms of depression (De Jonge et al., 2006; Schiffer et al., 2009).”
From Presence and predictors of pain in depression: Results from the FINDER study (2010) · cites this paper as De Jonge et al., 2006
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“However, for a person who develops MD following major health problems, such as myocardial infarction, the route to MD may follow a different path and, for instance, start with somatic symptoms (De Jonge et al. 2006).”
BackgroundLichtman, J. H., Froelicher, E. S., Blumenthal, J. A., Carney, R. M., Doering, L. V., Frasure-Smith, N., Freedland, K. E., Jaffe, A. S., Leifheit-Limson, E. C., Sheps, D. S., et al. (2014) · Circulation · doi:10.1161/cir.0000000000000019 · Cited by 1,208
Jackson, J. C., Pandharipande, P. P., Girard, T. D., Brummel, N. E., Thompson, J. L., Hughes, C. G., Pun, B. T., Vasilevskis, E. E., Morandi, A., Shintani, A. K., et al. (2014) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(14)70051-7 · Cited by 673
Molendijk, M., Molero, P., Ortuño Sánchez-Pedreño, F., Van der Does, W., & Angel Martínez-González, M. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2017.09.022 · Cited by 550
“Dietary exposure is linked to metabolic disease onset (Fontana & Partridge 2015) and this group of diseases shares symptoms with depression (e.g., fatigue) also when comorbidity between the two is not present (De Jonge et al., 2006).”
BackgroundSareen, J., Cox, B. J., Stein, M. B., Afifi, T. O., Fleet, C., & Asmundson, G. J. G. (2007) · Psychosomatic Medicine · doi:10.1097/psy.0b013e31803146d8 · Cited by 573
“To adjust for the effects of medical morbidity, we used the empirically validated and commonly used Charlson Comorbidity Index (43,44,45), which was developed empirically to index medical conditions that singly, or in combination, increase the shortterm risk of mortality (46,47).”
MethodInfluential
Metadata
- Authors
- de Jonge, P., Ormel, J., van den Brink, R. H. S., van Melle, J. P., Spijkerman, T. A., Kuijper, A., van Veldhuisen, D. J., van den Berg, M. P., Honig, A., Crijns, H. J. G. M., & Schene, A. H.
- Venue
- American Journal of Psychiatry
- Published
- 2006-01
- Volume
- 163
- Issue
- 1
- Pages
- 138-144
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W2148022279
- Cited by
- 250
- References
- 33
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 1 · 2023: 5 · 2022: 6 · 2021: 4 · 2020: 8 · 2019: 7 · 2018: 3 · 2017: 9 · 2016: 11 · 2015: 18 · 2014: 15 · 2013: 19 · 2012: 21
- FWCI
- 16.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- post-myocardial infarction depression, cognitive-affective symptoms, cardiovascular prognosis, cardiovascular mortality, cardiac readmission, left ventricular ejection fraction, Charlson Comorbidity Index, Killip class, depression treatment
- MeSH terms
- Cause of Death, Cognition Disorders, Cross-Sectional Studies, Depressive Disorder, Factor Analysis, Statistical, Health Status, Humans, Myocardial Infarction, Netherlands, Personality Inventory, Prognosis, Prospective Studies, Recurrence, Risk Factors, Stroke Volume, Time Factors, Models, Statistical, Comorbidity, Survival Analysis, Death, Sudden, Cardiac
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