Clinical predictors of depression treatment outcomes in patients with coronary heart disease
Section snippets
Eligibility screening and recruitment
Patients were recruited between May 2009 and August 2013 at cardiology offices and diagnostic laboratories affiliated with Washington University School of Medicine and Barnes-Jewish Hospital of St. Louis. Consenting patients with CHD documented by coronary angiography, a history of coronary revascularization, or hospitalization for ACS, completed the Patient Health Questionnaire (PHQ-9) [27]. Patients were excluded from the study if they refused to participate or if their physician did not
Results
Five hundred seventy-one patients with documented CHD were screened for eligibility. Of these, 157 (27%) had major depression, met all study criteria, and provided written informed consent. Of the enrolled participants, 126 (80%) completed all requirements of the study including the recommended number of CBT sessions and all post-treatment assessments. Those who did not complete all study requirements were less likely to have finished high school (80% vs. 96%; p = 0.002) and to be Caucasian (70%
Discussion
Clinical trials have found that patients with CHD who have a poor response to standard depression treatments experience higher rates of cardiac morbidity and mortality than those whose depression symptoms improve [7], [8], [9], [10], [11], [12]. Little is known about predictors of response to depression treatment in patients with CHD. In this study, the pre-treatment severity of depression predicted post-treatment BDI-II scores, suggesting that severe depression in patients with CHD may be less
Competing interest statement
All authors have completed the Unified Competing Interest form and declare that they have only received support from the National Institutes of Health, USA, for the submitted work. Dr. Carney or a member of his family owns stock in Pfizer, Inc. The other authors report no potential relevant conflicts of interest.
Acknowledgements
This research study was supported by grant number R01HL089336 from the National Heart, Lung, and Blood Institute of the National Institutes of Health, Bethesda, Maryland. The authors thank Patricia Herzing, RN; Iris Csik, ACSW; Jessica McDaniel, MA; Carol Sparks, LPN; and Kimberly Metze, BS for their contributions to the study.
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