The effects of depression and anxiety on mortality, CHD incidence, and quality-of-life after myocardial infarction.
The main purpose of this study was to determine the impact of depression and anxiety on
mortality, CHD incidence, and quality-of-life in patients hospitalised for an acute myocardial
infarction (MI). Questionnaires, including the Beck Depression Inventory (BDI) and the
State-Trait Anxiety Inventory were completed during hospitalisation by 288 MI patients, and
four months and 12 months after discharge among survivors. Quality-of-life was assessed at
both follow-up points using the Dartmouth COOP charts. Twenty-five (8.7%) patients died,
22 of cardiac causes, during the four month follow-up. Six further fatalities occurred
between four and 12 months following MI. Symptoms of depression and anxiety did not
predict either cardiac or all-cause mortality, or CHD incidence at either follow-up point.
Indices of disease severity predicted both four month and 12 month mortality and CHD
incidence. In a subset of seven patients who died prior to discharge, depressive symptoms
did predict mortality, but the association did not withstand correction for severity of
infarction. Multiple regression analyses revealed that baseline depression and state anxiety,
as well as severity of infarction, predicted both four and 12 month quality-of-life. In
addition, partner status and living alone also predicted four and 12 month quality-of-life,
respectively. Attendance at rehabilitation was positively associated with quality-of-life at
both four and 12 months, and negatively associated with 12 month CHD morbidity. In
conclusion, depression and anxiety were not significant predictors of mortality, or CHD
incidence, during the first year following MI but they were predictive of four and 12 month
quality-of-life among survivors.