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Relative lack of depressive cognitions in post-myocardial infarction depression☆

2006; Elsevier BV; Volume: 94; Issue: 1-3 Linguagem: Inglês

10.1016/j.jad.2006.04.023

1573-2517

Eimo Martens, Johan Denollet, Susanne S. Pedersen, M. J. W. T. Scherders, Eric Griez, Jos Widdershoven, Balász M. Szabó, Hans Bonnier, Ad Appels,

Takotsubo Cardiomyopathy and Associated Phenomena

Depression has been associated with adverse clinical events in myocardial infarction (MI) patients, but many questions about the nature of post-MI depression remain unanswered. We examined whether depressive cognitions characteristic of depression in psychiatric patients are also present in post-MI patients with major depression (MD). Non-depressed (n = 40) and depressed (n = 40) post-MI patients, and psychiatric outpatients (n = 40) treated for clinical depression, matched on age and sex, were interviewed using a structured clinical interview to diagnose DSM-IV MD. All patients also completed the Beck Depression Inventory (BDI) and the Beck Cognition Checklist-Depression subscale (CCL-D). Mean levels of depressive cognitions were considerably higher in depressed psychiatric patients compared with depressed post-MI patients (34.9 versus 28.0; p = .013), and higher in depressed post-MI patients compared with non-depressed post-MI patients (28.0 versus 17.8; p < .0001), adjusted for age, sex, educational level, and marital status. Younger age (p = .024), absence of a partner (p = .016) and depressed psychiatric status (p = .016) were independently associated with depressive cognitions. Psychiatric patients also had higher mean levels of depressive symptoms as compared to depressed post-MI patients (25.1 versus 17.8; p = .001). This study is based on a cross-sectional design. The symptom presentation of MD in post-MI patients is both quantitatively and qualitatively different from that seen in psychiatric patients, suggesting that depressive symptoms in post-MI patients differ in content from those in psychiatric patients. These findings could have important consequences for the design and contents of therapeutic programs for treating depression in post-MI patients.