Key result
Loss of energy was the most frequently reported depressive symptom (74.9%) and the only symptom that reliably predicted low quality of life, angina pectoris, and dyspnea in patients with coronary heart disease.
Cross-Sectional (n=1,337)
Yes
Individual depressive symptoms vary widely in frequency among CHD patients, with loss of energy being highly prevalent and uniquely predictive of worse cardiac symptoms and lower quality of life.
Loss of energy may identify CHD patients with worse symptoms and QoL; cross-sectional data leave open whether targeting it improves outcomes.
BACKGROUND: Major depression is common in coronary heart disease (CHD) but challenging to diagnose. Instead of focusing on the overall diagnosis of depression, base rates of depressive symptoms could facilitate screening and management of psychopathology in CHD. The present study investigates the frequency of individual depressive symptoms in CHD and their impact on cardiac and subjective health. METHODS: In total, 1337 in- and outpatients with CHD were screened for depressive symptoms with the Patient Health Questionnaire-9 (PHQ-9) at three different cardiac treatment sites. Tables stratified by age and gender were designed to illustrate base rates of depressive symptoms. Multiple regression analyses adjusted for sociodemographic and clinical data were conducted to test associations between individual depressive symptoms and quality of life as well impairment caused angina pectoris and dyspnea. RESULTS: During the last 14 days, more than half of patients reported a loss of energy (74.9%, 95% Confidence Interval (CI): 70.6-79.2), sleeping problems (69.4%, 95% CI: 64.9-74.0), loss of interest (55.7%, 95% CI: 50.8-60.7). In contrast, psychomotor change (25.6%, 95%CI: 21.3-30.0), feelings of failure (21.9%, 95%CI: 17.7-26.0), suicidal ideations (14.1%, 95%CI: 10.7-17.6) were less frequently reported. Depending on the outcome, only particular depressive symptoms were highly associated with low quality of life and impairment caused by angina pectoris and dyspnea. Loss of energy was the only depressive symptom that reliably predicted all three outcomes. CONCLUSIONS: Depressive symptoms in CHD are frequent but vary widely in terms of frequency. Findings underline the differential effects of individual depressive symptoms on cardiac health. Presented base rates of depressive symptoms offer clinicians a new way to judge the severity of individual depressive symptoms and to communicate individual PHQ-9 profiles with patients with respect to gender, age, cardiac symptoms and quality of life.
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Kohlmann et al. (2016) conducted a cross-sectional in Coronary heart disease (n=1,337). Depressive symptoms was evaluated on Frequency of loss of energy (95% CI 70.6-79.2). Loss of energy was the most frequently reported depressive symptom (74.9%) and the only symptom that reliably predicted low quality of life, angina pectoris, and dyspnea in patients with coronary heart disease.
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