Anxiety enhances the detrimental effect of depressive symptoms on health status following percutaneous coronary intervention

Pedersen, Susanne S.; Denollet, Johan; Spindler, Helle; Ong, Andrew T.L.; Serruys, Patrick W.; Erdman, Ruud A.M.; van Domburg, Ron T.

doi:10.1016/j.jpsychores.2006.06.009

« Previous Next »Journal of Psychosomatic Research
Volume 61, Issue 6 , Pages 783-789, December 2006

Anxiety enhances the detrimental effect of depressive symptoms on health status following percutaneous coronary intervention

Susanne S. Pedersen
- Department of Cardiology, Thoraxcentre, Erasmus Medical Centre Rotterdam, The Netherlands
- Centre of Research on Psychology in Somatic diseases (CoRPS), Tilburg University, The Netherlands
- Corresponding author. CoRPS, Department of Medical Psychology, Room P503a, Tilburg University, Warandelaan 2, PO Box 90153, 5000 LE Tilburg, The Netherlands. Tel.: +31 13 466 2503; fax: +31 13 466 2370.
Johan Denollet
- Centre of Research on Psychology in Somatic diseases (CoRPS), Tilburg University, The Netherlands
Helle Spindler
- Department of Psychology, Aarhus University, Denmark
Andrew T.L. Ong
- Department of Cardiology, Thoraxcentre, Erasmus Medical Centre Rotterdam, The Netherlands
Patrick W. Serruys
- Department of Cardiology, Thoraxcentre, Erasmus Medical Centre Rotterdam, The Netherlands
Ruud A.M. Erdman
- Department of Cardiology, Thoraxcentre, Erasmus Medical Centre Rotterdam, The Netherlands
- Department of Medical Psychology and Psychotherapy, Erasmus Medical Centre Rotterdam, The Netherlands
Ron T. van Domburg
- Department of Cardiology, Thoraxcentre, Erasmus Medical Centre Rotterdam, The Netherlands

Received 10 February 2006; received in revised form 23 May 2006; accepted 27 June 2006.

Abstract

Objective

We examined whether anxiety has incremental value to depressive symptoms in predicting health status in patients undergoing percutaneous coronary intervention (PCI) treated in the drug-eluting stent era.

Methods

A series of consecutive patients (n=692) undergoing PCI as part of the Rapamycin-Eluting Stent Evaluated at Rotterdam Cardiology Hospital registry completed the Hospital Anxiety and Depression Scale at 6 months and the Short-Form Health Survey (SF-36) at 6 and 12 months post-PCI.

Results

Of 692 patients, 471 (68.1%) had no symptoms of anxiety nor depression, 62 (9.0%) had anxiety only, 59 (8.5%) had depressive symptoms only, and 100 (14.5%) had co-occurring symptoms. There was an overall significant improvement in health status between 6 and 12 months post-PCI (P<.001); the interaction effect for time by psychological symptoms was also significant (P=.003). Generally, patients with co-occurring symptoms reported significantly poorer health status compared with the other three groups (Ps <.001). Patients with co-occurring symptomatology were also at greater risk of impaired health status on six of the eight subdomains of the SF-36 compared with the other three symptom groups, adjusting for baseline characteristics and health status at 6 months.

Conclusion

Patients with co-occurring symptoms of anxiety and depression reported poorer health status compared with anxious or depressed-only patients and no-symptom patients, showing that anxiety has incremental value to depressive symptoms in identifying PCI patients at risk for impaired health status treated in the drug-eluting stent era.

Keywords: Anxiety, Depressive symptoms, Drug-eluting stents, Health status, Percutaneous coronary intervention