A total of 197 patients were included in this study, of which 97 patients scored ≥10 on the BDI. shows that patients with depressive symptoms were more likely to be female and unmarried. When comparing age, race, education level, or comorbidities, no differences were observed between patients who reported depressive symptoms and those who were asymptomatic. The prevalence of patients with BDI scores ≥10 was similar among those discharged after ST elevation MI, non-ST elevation MI, and elective coronary angiography.
Baseline and clinical characteristics by BDI score among cardiac patients
We examined components of the MOS social support survey among those who reported any depressive symptoms compared to those who reported no depressive symptoms (). Patients who scored ≥10 on the BDI were more likely to have lower scores for emotional or informational support, tangible support, and positive social support, compared to those who had a BDI < 10. No difference was noted between the two groups for affectionate support. The total MOS social support survey score was lower for those who scored ≥10 in the BDI compared to those who had a BDI score of below 10 (74.3 vs 79.6, P = 0.03).
Domains of social support (MOS) by BDI score among cardiac patients
In terms of quality of life (QOL) measures, we examined the domains of the SF-36 by the BDI group (). Patients with depressive symptoms were more likely to report physical limitations compared to nondepressed patients. Patients who scored ≥10 on the BDI scored lower on both the domains of physical function, and role limitations due to physical problems. A difference in reported bodily pain was also observed in patients who had depressive symptoms, these having a higher bodily pain score compared to those without depression (6.1 vs 4.5, P < 0.0001). Differences were also observed for role limitations due to emotional problems (4.9 for those with a BDI ≥ 10 vs 5.5 for those with a BDI < 10, P < 0.001). No statistically significant differences were observed for items related to general health perceptions, vitality, social functioning, and mental health.
Domains of functioning (SF-36) by BDI score among cardiac patients
To examine predictors of depressive symptoms in this population, we compared models incorporating factors from the SF-36 and MOS social support survey, which differed by BDI score.
In the model which included domains of the SF-36 in addition to baseline and clinical characteristics, bodily pain was associated with depressive symptoms defined as the groups with a BDI score ≥10 (OR: 1.39, 95% confidence interval [CI]: 1.16–1.68, P < 0.001). Being married reduced the odds of a BDI score ≥10 (OR: 0.44, 95% CI: 0.22–0.88, P = 0.02). When adding all the components of the MOS social support survey to the model, tangible support, vitality, and bodily pain scores were significant predictors of differences in BDI groups (ie, reporting depressive symptoms or not). When sex and marital status were added to the model, the MOS social support factors were no longer statistically significant; while female sex appeared to increase the odds of reporting depressive symptoms (OR: 2.11, 95% CI: 1.08–4.12, P = 0.03). A trend towards decreased odds of a BDI score of ≥10 was observed in those who were married, which was not statistically significant (OR: 0.65, 95% CI: 0.34–1.23, P = 0.18). Combining the factors from both the MOS social support survey and the SF-36 in a stepwise prediction model, we found that only four factors, namely tangible support, bodily pain, vitality, and mental health were significant predictors of reporting depressive symptoms, defined as a BDI score of ≥10 ().
Predictors of a BDI score ≥ 10 among cardiac patients