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Red flags for persistent or worsening anxiety and depression after an acute cardiac event: a 6-month longitudinal study in regional and rural Australia.
Eur J Prev Cardiol. 2014 Sep; 21(9):1079-89.EJ

Abstract

BACKGROUND

While early symptoms of anxiety and depression resolve for many patients soon after an acute cardiac event, the persistence or worsening of symptoms indicates increased mortality risk. It is therefore important to identify the predictors, or red flags, of persistent or worsening anxiety and depression symptoms. Most previous research has focussed on metropolitan patients, hence the need for studies of regional and rural dwellers.

METHOD

In this study, 160 cardiac patients consecutively admitted to two hospitals in regional Victoria, Australia, were interviewed in hospital and 2 and 6 months after discharge. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale. Growth mixture modelling was used to identify the trajectories of anxiety and depression over the 6 months after the acute event, and post-hoc tests identified predictors of persistent or worsening symptoms.

RESULTS

For both anxiety and depression, three common symptom trajectories were identified. Inhospital anxiety symptoms tended to persist over time, whereas inhospital depression symptoms resolved for some patients and worsened for others. A mental health history, younger age, smoking, financial stress, poor self-rated health, and social isolation were red flags for persistent anxiety and worsening depression. Additionally, diabetes, and other comorbidities were red flags for persistent anxiety.

CONCLUSIONS

The results highlight several potential red flags for increased risk of persistent anxiety or worsening depressive symptoms after a cardiac event, including demographic, psychosocial, and behavioural indicators. These red flags could assist with identification of at-risk patients on admission to or discharge from hospital, thereby enabling targeting of interventions.

Authors+Show Affiliations

Heart Research Centre, Melbourne, VIC, Australia University of Melbourne, VIC, Australia.Heart Research Centre, Melbourne, VIC, Australia barbara.murphy@heartresearchcentre.org.Heart Research Centre, Melbourne, VIC, Australia University of Melbourne, VIC, Australia.University of Melbourne, VIC, Australia.Monash University, VIC, Australia.Bendigo Health, VIC, Australia.Bendigo Health, VIC, Australia St John of God Hospital, Bendigo, VIC, Australia.Heart Research Centre, Melbourne, VIC, Australia University of Melbourne, VIC, Australia.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23733741

Citation

Murphy, Barbara, et al. "Red Flags for Persistent or Worsening Anxiety and Depression After an Acute Cardiac Event: a 6-month Longitudinal Study in Regional and Rural Australia." European Journal of Preventive Cardiology, vol. 21, no. 9, 2014, pp. 1079-89.
Murphy B, Ludeman D, Elliott P, et al. Red flags for persistent or worsening anxiety and depression after an acute cardiac event: a 6-month longitudinal study in regional and rural Australia. Eur J Prev Cardiol. 2014;21(9):1079-89.
Murphy, B., Ludeman, D., Elliott, P., Judd, F., Humphreys, J., Edington, J., Jackson, A., & Worcester, M. (2014). Red flags for persistent or worsening anxiety and depression after an acute cardiac event: a 6-month longitudinal study in regional and rural Australia. European Journal of Preventive Cardiology, 21(9), 1079-89. https://doi.org/10.1177/2047487313493058
Murphy B, et al. Red Flags for Persistent or Worsening Anxiety and Depression After an Acute Cardiac Event: a 6-month Longitudinal Study in Regional and Rural Australia. Eur J Prev Cardiol. 2014;21(9):1079-89. PubMed PMID: 23733741.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Red flags for persistent or worsening anxiety and depression after an acute cardiac event: a 6-month longitudinal study in regional and rural Australia. AU - Murphy,Barbara, AU - Ludeman,Deborah, AU - Elliott,Peter, AU - Judd,Fiona, AU - Humphreys,John, AU - Edington,John, AU - Jackson,Anthony, AU - Worcester,Marian, Y1 - 2013/06/03/ PY - 2013/6/5/entrez PY - 2013/6/5/pubmed PY - 2015/5/13/medline KW - Anxiety KW - coronary heart disease KW - depression KW - risk factors KW - screening SP - 1079 EP - 89 JF - European journal of preventive cardiology JO - Eur J Prev Cardiol VL - 21 IS - 9 N2 - BACKGROUND: While early symptoms of anxiety and depression resolve for many patients soon after an acute cardiac event, the persistence or worsening of symptoms indicates increased mortality risk. It is therefore important to identify the predictors, or red flags, of persistent or worsening anxiety and depression symptoms. Most previous research has focussed on metropolitan patients, hence the need for studies of regional and rural dwellers. METHOD: In this study, 160 cardiac patients consecutively admitted to two hospitals in regional Victoria, Australia, were interviewed in hospital and 2 and 6 months after discharge. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale. Growth mixture modelling was used to identify the trajectories of anxiety and depression over the 6 months after the acute event, and post-hoc tests identified predictors of persistent or worsening symptoms. RESULTS: For both anxiety and depression, three common symptom trajectories were identified. Inhospital anxiety symptoms tended to persist over time, whereas inhospital depression symptoms resolved for some patients and worsened for others. A mental health history, younger age, smoking, financial stress, poor self-rated health, and social isolation were red flags for persistent anxiety and worsening depression. Additionally, diabetes, and other comorbidities were red flags for persistent anxiety. CONCLUSIONS: The results highlight several potential red flags for increased risk of persistent anxiety or worsening depressive symptoms after a cardiac event, including demographic, psychosocial, and behavioural indicators. These red flags could assist with identification of at-risk patients on admission to or discharge from hospital, thereby enabling targeting of interventions. SN - 2047-4881 UR - https://www.unboundmedicine.com/medline/citation/23733741/Red_flags_for_persistent_or_worsening_anxiety_and_depression_after_an_acute_cardiac_event:_a_6_month_longitudinal_study_in_regional_and_rural_Australia_ L2 - http://journals.sagepub.com/doi/full/10.1177/2047487313493058?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -