Social support, depression, and mortality during the first year after myocardial infarction
Social support, depression, and mortality during the first year after myocardial infarction
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DOI：
10.1161/01.cir.101.16.1919
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发表时间：
2000-04-25
期刊：
影响因子：
37.8
通讯作者：
Bourassa, MG
中科院分区：
文献类型：
--
作者：
Frasure-Smith, N;Lespérance, F;Bourassa, MG
背景-我们以前报道过心肌梗死（MI）后的抑郁会增加心源性死亡的长期风险。其他研究表明，社会支持也可能影响预后。本文探讨基线抑郁症和社会支持之间的相互关系，心脏预后和抑郁症状的变化，在第一个后MI year.Methods和Results-For这项研究，887例患者完成了贝克抑郁量表（BDI）和领悟社会支持量表（PSSS）在MI后约7天。大约32%的人的BMI大于或等于10，表明轻度至中度抑郁。确定所有患者的1年生存状态。对89%的幸存者进行了后续访谈，包括BDI。有39例死亡（35例心源性）。BDI评分升高与心源性死亡率相关（P=0.0006），但PSSS评分和其他社会支持指标与此无关。抑郁与PSSS之间存在显著的交互作用（P=0.016）。抑郁症和心源性死亡率之间的关系下降，增加支持，此外，残差变化评分分析显示，1年的幸存者谁一直在基线抑郁，更高的基线社会支持与更多的改善抑郁症状比expected.Conclusions-Post-MI抑郁症是一个预测1年的心源性死亡率，但社会支持是没有直接关系的生存。然而，非常高水平的支持似乎缓冲了抑郁症对死亡率的影响。此外，高水平的支持预测抑郁症患者在MI后第一年抑郁症状的改善。高水平的支持可以保护患者免受抑郁症的负面预后后果，因为抑郁症症状的改善。
Background-We previously reported that depression after myocardial infarction (MI) increases the long-term risk of cardiac mortality. Other research suggests that social support may also influence prognosis. This article examines the interrelationships between baseline depression and social support in terms of cardiac prognosis and changes in depression symptoms over the first post-MI year.Methods and Results-For this study, 887 patients completed the Beck Depression Inventory (BDI) and the Perceived Social Support Scale (PSSS) at about 7 days after MI. Some 32% had BDIs greater than or equal to 10, indicating mild to moderate depression. One-year survival status was determined for all patients. Follow-up interviews, including the BDI, were conducted with 89% of survivors. There were 39 deaths (35 cardiac). Elevated BDI scores were related to cardiac mortality (P=0.0006), but PSSS scores and other measures of social support were not. There was a significant interaction between depression and the PSSS (P=0.016). The relationship between depression and cardiac mortality decreased with increasing support, Furthermore, residual change score analysis revealed that among 1-year survivors who had been depressed at baseline, higher baseline social support was related to more improvement in depression symptoms than expected.Conclusions-Post-MI depression is a predictor of 1-year cardiac mortality, but social support is not directly related to survival. However, very high levels of support appear to buffer the impact of depression on mortality. Furthermore, high levels of support predict improvements in depression symptoms over the first post-MI year in depressed patients. High levels of support may protect patients from the negative prognostic consequences of depression because of improvements in depression symptoms.