Major depression before and after myocardial infarction: Its nature and consequences
Major depression before and after myocardial infarction: Its nature and consequences
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DOI：
10.1097/00006842-199603000-00001
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发表时间：
1996-03-01
影响因子：
3.3
通讯作者：
Talajic, M
中科院分区：
文献类型：
--
作者：
Lesperance, F;FrasureSmith, N;Talajic, M
研究人员对 222 名因急性心肌梗塞 (MI) 入院的患者进行了研究，研究了既往抑郁症、住院期间抑郁症以及出院后抑郁症的患病率和预后影响。在指数 MI 发生后 1 周、6 个月和 12 个月，使用诊断访谈计划 (DIS) 的修改版本对患者进行访谈；患者还完成了贝克抑郁量表（BDI）。 18 个月时再次联系患者或家属以确定生存情况。约 27.5% 的患者在发生心肌梗塞之前至少有过一次重度抑郁症发作，但只有 7.7% 的患者在梗塞前一年的某个时间点出现过抑郁症。总体而言，31.5% 的患者在医院内或出院后一年内经历过抑郁症。大约 35 名患者在医院内出现抑郁症，其中 30 名患者在出院后至 6 个月期间出现抑郁症，另有 5 名患者在 MI 后 6 至 12 个月内出现抑郁症。抑郁史会增加住院期间和出院后患抑郁症的风险。医院抑郁症与 18 个月内死亡风险增加相关。在医院经历过复发性抑郁症的患者风险尤其高。尽管出院后变得抑郁的患者与未患抑郁症的患者在年龄、抑郁病史、BDI 评分以及医院 DIS 上抑郁症状的数量方面有所不同，但包含这些变量的模型仅识别出 14.7% 的回家后变得抑郁的患者。心肌梗死后抑郁症很常见，并且很大程度上与医疗和心理社会因素无关。
The prevalence and prognostic impact of previous depression, depression in the hospital, and depression after discharge were studied in 222 patients admitted for acute myocardial infarction (MI). Patients were interviewed 1 week, 6 months, and 12 months after the index MI using a modified version of the Diagnostic Interview Schedule (DIS); patients also completed the Beck Depression Inventory (BDI). Patients or family members were recontacted at 18 months to determine survival. Some 27.5% of patients had at least one episode of major depression before their MI, but only 7.7% were depressed at some point during the year preceding the infarct. Overall, 31.5% of patients experienced depression in the hospital or during the year postdischarge. Some 35 patients were depressed in the hospital, 30 became depressed between discharge and 6 months, and five more between 6 and 12 months after the MI. History of depression increased the risk of depression in the hospital and after discharge. Depression in the hospital was associated with an increased risk of mortality over 18 months. Patients who experienced a recurrent depression in the hospital were at particularly high risk. Although patients who became depressed after discharge differed from those who remained depression-free in terms of age, history of depression, BDI scores, and the number of depression symptoms on the DIS in the hospital, a model including these variables identified only 14.7% of the patients who became depressed after returning home. Post-MI depression is common and largely unrelated to medical and psychosocial factors.