scholarly journals Depressive Symptoms at Discharge from Rehabilitation Predict Future Cardiovascular-Related Hospitalizations

Cardiology ◽  
2015 ◽  
Vol 131 (2) ◽  
pp. 80-85 ◽  
Author(s):  
Fiorenza Angela Meyer ◽  
Eva Hugentobler ◽  
Stefanie Stauber ◽  
Matthias Wilhelm ◽  
Hansjörg Znoj ◽  
...  

Objectives: Depression is associated with poor prognosis in patients with cardiovascular disease (CVD). We hypothesized that depressive symptoms at discharge from a cardiac rehabilitation program are associated with an increased risk of future CVD-related hospitalizations. Methods: We examined 486 CVD patients (mean age = 59.8 ± 11.2) who enrolled in a comprehensive 3-month rehabilitation program and completed the depression subscale of the Hospital Anxiety and Depression Scale (HADS-D). At follow-up we evaluated the predictive value of depressive symptoms for CVD-related hospitalizations, controlling for sociodemographic factors, cardiovascular risk factors, and disease severity. Results: During a mean follow-up of 41.5 ± 15.6 months, 63 patients experienced a CVD-related hospitalization. The percentage of depressive patients (HADS-D ≥8) decreased from 16.9% at rehabilitation entry to 10.7% at discharge. Depressive symptoms at discharge from rehabilitation were a significant predictor of outcome (HR 1.32, 95% CI 1.09-1.60; p = 0.004). Patients with clinically relevant depressive symptoms at discharge had a 2.5-fold increased relative risk of poor cardiac prognosis compared to patients without clinically relevant depressive symptoms independently of other prognostic variables. Conclusion: In patients with CVD, depressive symptoms at discharge from rehabilitation indicated a poor cardiac prognosis.

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Magnus Johansson ◽  
Markus Jansson-Fröjmark ◽  
Annika Norell-Clarke ◽  
Steven J. Linton

Abstract Background The aim of this investigation was to examine the longitudinal association between change in insomnia status and the development of anxiety and depression in the general population. Methods A survey was mailed to 5000 randomly selected individuals (aged 18–70 years) in two Swedish counties. After 6 months, a follow-up survey was sent to those (n = 2333) who answered the first questionnaire. The follow-up survey was completed by 1887 individuals (80.9%). The survey consisted of questions indexing insomnia symptomatology, socio-demographic parameters, and the Hospital Anxiety and Depression Scale. Change in insomnia status was assessed by determining insomnia at the two time-points and then calculating a change index reflecting incidence (from non-insomnia to insomnia), remission (from insomnia to non-insomnia), or status quo (no change). Multivariate binary logistic regression analyses were used to examine the aim. Results Incident insomnia was significantly associated with an increased risk for the development of new cases of both anxiety (OR = 0.32, p < .05) and depression (OR = 0.43, p < .05) 6 months later. Incident insomnia emerged also as significantly associated with an elevated risk for the persistence of depression (OR = 0.30, p < .05), but not for anxiety. Conclusions This study extends previous research in that incidence in insomnia was shown to independently increase the risk for the development of anxiety and depression as well as for the maintenance of depression. The findings imply that insomnia may be viewed as a dynamic risk factor for anxiety and depression, which might have implications for preventative work.


2021 ◽  
Vol 6 (1) ◽  
pp. 9-13
Author(s):  
Suriati Mohamed Saini ◽  
Susan Tan Mooi Koon ◽  
Mohamad Adam Bujang ◽  
Gerard Lim Chin Chye ◽  
Shalisah Sharip ◽  
...  

Introduction: Anxiety and depression occur at a high rate in cancer patients. However, debate remains regarding the effect of anxiety and depression on cancer survival. Objective: This study aimed to determine the effect of anxiety and depressive symptoms on the survival of cancer patients. Methods: The subjects consisted of 112 cancer patients who attended the Oncology and Radiotherapy outpatient clinic Hospital Kuala Lumpur, Malaysia, in 1999. Anxiety and depressive symptoms were measured using the Hospital Anxiety and Depression Scale (HADS) questionnaire at inception. Information on patients’ mortality status for extended 13 years follow-up (in 2011) was obtained from the National Registration Department death records. Overall survival for each anxiety and depressive symptoms scores in HADS at 13 years was calculated using Cox proportional hazards regression analysis. Results: Cancer patients experienced more anxiety (83%) compared to depressive symptoms (40.2%). The mean (S.D.) HADS scores for depressive symptoms were 9.9 (2.5), and the anxiety symptoms score was 12.6 (2.1). At 13 years, half of the patients (50.9%) had died. No significant effect of anxiety (p=0.399, 95% C.I.= 6.2-8.4) or depressive symptoms at inception (p=0.749, 95% C.I.= 5.9-8.4) towards cancer patients’ survival was found at 13 years follow-up. Conclusion: The occurrence of anxiety symptoms among cancer patients in this study was 2-folds higher than depressive symptoms. However, no significant increased risk of death was found in cancer patients with anxiety or depressive symptoms at 13 years follow-up. It may imply that as time extended, survival in cancer patients may be related to various interacting elements, and intervening health factors are of importance.


2015 ◽  
Vol 27 (9) ◽  
pp. 1577-1578 ◽  
Author(s):  
Guy Campbell ◽  
Christina Bryant ◽  
Kathryn A. Ellis ◽  
Rachel Buckley ◽  
David Ames ◽  
...  

Screening measures such as the 15-item Geriatric Depression Scale (GDS-15) (Sheikh and Yesavage, 1986) and the Hospital Anxiety and Depression Scale (HADS) (Zigmond and Snaith, 1983) are important tools in the recognition of depressive symptoms in older people. While these measures are widely used, there is evidence of specific weaknesses in some cohorts and contexts, with the GDS-15 showing limitations in the context of cognitive impairment (Gilley and Wilson, 1997), and the depression subscale of the HADS (HADS-D) losing sensitivity in the context of older participants in hospital inpatient settings (Davies et al., 1993).


2021 ◽  
Vol 36 (6) ◽  
pp. 1171-1171
Author(s):  
Winter Olmos ◽  
Daniel W Lopez-Hernandez ◽  
Isabel Munoz ◽  
Laura Schierholz ◽  
Rachel A Rugh-Fraser ◽  
...  

Abstract Introduction We examined the relationship between depression and anxiety, language, and functional outcomes in persons with traumatic brain injury (TBI). Methods The sample consisted of 48 acute TBI (ATBI: 23 Spanish-English Bilinguals; 25 English monolinguals), 30 chronic TBI (CTBI: 17 Spanish English Bilinguals; 12 English monolinguals), and 47 healthy comparison (HC: 29 Spanish-English Bilinguals; 18 English monolinguals) participants. The Hospital Anxiety and Depression Scale was used to measure depression (HADS-D) and anxiety (HADS-A). The Mayo Portland Adaptability Inventory-4 (MPAI-4) was used to measure functional outcomes (ability, adjustment, participation). Results An ANCOVA, controlling for age, revealed the ATBI group reported lower anxiety levels compared to the CTBI group, p = 0.034 np2 = 0.06. HC participants demonstrated significantly higher functional ability compared to both TBI groups, p &lt; 0.05, np2 = 0.08–0.19. The ATBI group demonstrated worse participation scores compared to the CTBI and HC groups, p = 0.001, np2 = 0.11. Pearson correlations revealed mood was related to functional status in ATBI monolinguals (HADS-A: r = 0.29–0.64; HADS-D, r = 0.49–0.62). Monolingual participants with ATBI demonstrated correlations between depressive symptoms and functional adjustment (r = 0.57, p = 0.005) and ability (r = 0.44, p = 0.034). For monolinguals with CTBI, HADS-A correlated with functional outcomes, r = 0.60–0.66, p &lt; 0.05. For bilinguals with CTBI, functional outcomes correlated with HADS-A, r = 0.53–0.66, p &lt; 0.05, and HADS-D, r = 0.54–0.66, p &lt; 0.05. For HC monolinguals, functional outcomes correlated with HADS-A, r = 0.53–0.70, p &lt; 0.05, and HADS-D, r = 0.50–0.72, p &lt; 0.05. Finally, for HC bilinguals, functional outcomes correlated with HADS-A, r = 0.59–0.68, p &lt; 0.05. Conclusion Our results suggest that a relationship between anxiety and depressive symptoms is related more to functional outcomes in monolingual TBI survivors compared to bilingual TBI survivors.


2012 ◽  
Vol 70 (5) ◽  
pp. 352-356 ◽  
Author(s):  
Asdrubal Falavigna ◽  
Orlando Righesso ◽  
Alisson Roberto Teles ◽  
Natália Baseggio ◽  
Maíra Cristina Velho ◽  
...  

OBJECTIVE: To evaluate the accuracy of the Depression Subscale of Hospital Anxiety and Depression Scale (HADS-D) in spine surgery, comparing it to Beck Depression Inventory (BDI). METHODS: In a cross-sectional study, the HADS-D and the BDI were applied to patients undergoing spine surgery for lumbar (n=139) or cervical spondylosis (n=17). Spearman correlation tests for HADS-D and BDI were applied. The internal consistency of HADS-D was estimated by Cronbach's alpha coefficient. RESULTS: According to the BDI, the prevalence of depression was of 28.8% (n=45). The Spearman r coefficient between HADS-D and BDI was 0.714 (p<0.001). Cronbach's alpha for HADS-D was 0.795. The area of the ROC curve was 0.845. Using a cutoff for HADS-D >10, there was a sensitivity of 71.1%, specificity of 95.4%, and positive likelihood-ratio of 15.78. CONCLUSIONS: HADS-D showed a strong correlation with BDI and good reliability. HADS-D is a good alternative for screening depression and assessing its severity.


2019 ◽  
Vol 27 (4) ◽  
pp. 381-390 ◽  
Author(s):  
Mechthild Westhoff-Bleck ◽  
Lotta Winter ◽  
Lukas Aguirre Davila ◽  
Christoph Herrmann-Lingen ◽  
Jens Treptau ◽  
...  

Objective The purpose of this study was the diagnostic evaluation of the hospital anxiety and depression scale total score, its depression subscale and the Beck depression inventory II in adults with congenital heart disease. Methods This cross-sectional study evaluated 206 patients with congenital heart disease (mean age 35.3 ± 11.7 years; 58.3% men). Major depressive disorder was diagnosed by a structured clinical interview for the Diagnostic and Statistical Manual of Mental Disorders IV and disease severity with the Montgomery–Åsberg depression rating scale. Receiver operating characteristics provided assessment of diagnostic accuracy. Youden’s J statistic identified optimal cut-off points. Results Fifty-three participants (25.7%) presented with major depressive disorder. Of these, 28 (52.8%) had mild and 25 (47.2%) had moderate to severe symptoms. In the total cohort, the optimal cut-off of values was >11 in the Beck depression inventory II, >11 in the hospital anxiety and depression scale and >5 in the depression subscale. Optimal cut-off points for moderate to severe major depressive disorder were similar. The cut-offs for mild major depressive disorder were lower (Beck depression inventory II >4; hospital anxiety and depression scale >8; >2 in its depression subscale). In the total cohort the calculated area under the curve varied between 0.906 (hospital anxiety and depression scale) and 0.93 (Beck depression inventory II). Detection of moderate to severe major depressive disorder (area under the curve 0.965–0.98) was excellent; detection of mild major depressive disorder (area under the curve 0.851–0.885) was limited. Patients with major depressive disorder had a significantly lower quality of life, even when they had mild symptoms. Conclusion All scales were excellent for detecting moderate to severe major depressive disorder. Classification of mild major depressive disorder, representing 50% of cases, was limited. Therapy necessitating loss of quality of life is already present in major depressive disorder with mild symptoms. Established cut-off points may still be too high to identify patients with major depressive disorder requiring therapy. External validation is needed to confirm our data.


2021 ◽  
pp. 082585972110445
Author(s):  
Tina Lundberg ◽  
Kristofer Årestedt ◽  
Ulla Forinder ◽  
Mariann Olsson ◽  
Carl Johan Fürst ◽  
...  

Objective: The purpose of the study was to examine associations between self-esteem and symptoms of anxiety and depression among young adults who lost a parent to cancer. Methods: Older adolescents and young adults, aged 16 to 28 years, who had lost their parent to cancer and had accepted an invitation to join a support group, completed a questionnaire 5 to 8 months after the loss and a similar questionnaire about 10 months later (follow-up). Of a total of 77 young adults who participated in the study, 56 completed both questionnaires. Self-esteem was measured with the Rosenberg Self-Esteem Scale. Symptoms of anxiety and depression were measured with the Hospital Anxiety and Depression Scale. Univariate and multiple linear regression models were used to analyze the associations. Result: Self-esteem was significantly associated with symptoms of anxiety and depression at baseline and at follow-up. Conclusion: This study reveals that self-esteem is a valuable explanatory variable, and that it is associated with both symptoms of anxiety and depression in bereavement. This new knowledge could be used to guide future support to parentally bereaved young adults.


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