Prevalence of Cardiac Depression and its Related Factors among Patients with Acute Coronary Syndrome
Cardiac depression is one of the most common psychological reactions of patients with acute coronary syndrome (ACS).
This study aimed to determine the prevalence of cardiac depression and its related factors among patients with ACS. This
cross-sectional study was conducted during 2016 in patients with ACS who were admitted to hospitals affiliated to the
Mazandaran University of Medical Sciences, Iran. In the present study, 407 patients completed the Cardiac Depression
Scale (CDS) within two months (March - June). The data were analyzed by a chi-square test and a general linear model
multivariate analysis. According to the results, the mean cardiac depression score in patients with ACS was 109.00 ± 16.49
(CI95: 107.39 to 110.60). Among the participants, 37 (9.1%), 72 (17.7%), and 298 (73.2%) patients had mild, moderate,
and severe levels of depression, respectively. Although the two-way ANOVA was not significant, but there was a difference
between cardiac depression score of a type of ACS. Given the high prevalence of cardiac depression among these patients,
it is necessary to develop measures for routine screening in cardiac treatment units.
Estruch R, Ros E, Salas-Salvadó J, Covas MI, Corella D,
Arós F, Gómez-Gracia E, Ruiz-Gutiérrez V, Fiol M, Lapetra
J, Lamuela-Raventos RM. Primary prevention of cardiovascular
disease with a Mediterranean diet. New England
Journal of Medicine. 2013; 368(14):1279–90.
Basampour SS. The effect of education on anxiety before
and after open heart surgery. 2004.
Greenlund KJ, Keenan NL, Giles WH, Zheng ZJ, Neff LJ,
Croft JB, Mensah GA. Public recognition of major signs
and symptoms of heart attack: seventeen states and the
US Virgin Islands, 2001. American Heart Journal. 2004;
Naghavi M, Jafari N. Mortality in the 29 provinces of Iran
in 2004. Tehran: Vice-Chancellor for Health, Ministry of
Health and Medical Education. 2007.
Taghipour B, Nia HS, Soleimani MA, Afshar MH, Far SS.
Comparison of the clinical symptoms of myocardial infarction
in the middle-aged and elderly. Journal of Kermanshah
University of Medical Sciences. 2014; 18(5):40–45.
Abedini A, Akbari H. Comparison of different methods of
education on reducing the anxiety of patients with myocardial
infarction. Iran Journal of Nursing. 2012; 24(74):36–44.
Dunderdale K, Thompson DR, Miles JN, Beer SF, Furze G.
Quality‐of‐life measurement in chronic heart failure: do we
take account of the patient perspective? European Journal
of Heart Failure. 2005; 7(4):572–82.
Fried EI, Nesse RM. Depression sum-scores don’t add up:
why analyzing specific depression symptoms is essential.
BMC Medicine. 2015; 13(1):1–2.
Grippo AJ, Johnson AK. Biological mechanisms in the relationship
between depression and heart disease. Neuroscience
and Biobehavioral Reviews. 2002; 26(8):941–62.
Meneses R. Depression in patients with myocardial infarction.
Revista portuguesa de cardiologia: orgao oficial da Sociedade
Portuguesa de Cardiologia=Portuguese Journal of
Cardiology: an official Journal of the Portuguese Society of
Cardiology. 2007; 26(11):1143–65.
Jr CV. Association between depression and development of
coronary artery disease: pathophysiologic and diagnostic
implications. Vascular Health and Risk Management. 2011;
Schrader G, Cheok F, Hordacre AL, Guiver N. Predictors of
depression three months after cardiac hospitalization. Psychosomatic
Medicine. 2004; 66(4):514–20.
Lichtman JH, Bigger JT, Blumenthal JA, Frasure-Smith N,
Kaufmann PG, Lespérance F, Mark DB, Sheps DS, Taylor
CB, Froelicher ES. Depression and coronary heart disease
recommendations for screening, referral, and treatment:
a science advisory from the American Heart Association
Prevention Committee of the Council on Cardiovascular
Nursing, Council on Clinical Cardiology, Council on Epidemiology
and Prevention, and Interdisciplinary Council
on Quality of Care and Outcomes Research: endorsed by
the American Psychiatric Association. Circulation. 2008;
Williams RB. Depression after heart attack: why should I be
concerned about depression after a heart attack? Circulation.
Hosseini H, Tabiban S, Samarbakhsh A. Depression following
the first attack of myocardial infarction. Bimonthly Research
Journal Pejouhandeh. 2006; 5(10):317–20.
Carney RM, Blumenthal JA, Stein PK, Watkins L, Catellier
D, Berkman LF, Czajkowski SM, O’Connor C, Stone PH,
Freedland KE. Depression, heart rate variability, and acute
myocardial infarction. Circulation. 2001; 104(17):2024–8.
Wulsin LR, Singal BM. Do depressive symptoms increase
the risk for the onset of coronary disease? A systematic
quantitative review. Psychosomatic Medicine. 2003;
Bayani B, Yousefi S, Bayani M, Shirmohammadi M, Alimoradi
A, Falsoleiman H, Yazdi N, Arbabi M. Depression
and anxiety in a cardiovascular outpatient clinic: a descriptive
study. Iranian Journal of Psychiatry. 2011; 6(3):125.
Carney RM, Freedland KE, Jaffe AS. Insomnia and depression
prior to myocardial infarction. Psychosom Med. 1990;
Vol 8(S1) | 2016 | www.informaticsjournals.com/index.php/ajprhc Asian Journal of Pharmaceutical Research and Health Care 35
Amir Hossein Goudarzian, Hamid Sharif Nia, Heydar Tavakoli, Mohammad Ali Soleimani, Ameneh Yaghoobzadeh,
Fariba Tabari and Mozhgan Taebei
Mavrides N, Nemeroff C. Treatment of depression in
cardiovascular disease. Depression and Anxiety. 2013;
Sharif Nia H, Haghdoost AA, Nazari R, Bahrami N, Soleimani
MA, Pormand K. Relationship of risk factors and ST
segment changes with symptoms of acute coronary syndrome.
Koomesh. 2013 Sep 15; 15(1):46–53.
Hare DL, Davis CR. Cardiac depression scale: validation of
a new depression scale for cardiac patients. Journal of Psychosomatic
Research. 1996; 40(4):379–86.
Wang W, Thompson DR, Chair SY, Hare DL. A psychometric
evaluation of a Chinese version of the Cardiac Depression
Scale. Journal of Psychosomatic Research. 2008;
Di Benedetto M, Lindner H, Hare DL, Kent S. Depression
following acute coronary syndromes: a comparison between
the cardiac depression scale and the Beck depression
inventory II. Journal of Psychosomatic Research. 2006;
Perez GH, Nicolau JC, Romano BW, Laranjeira R. Depression
and acute coronary syndromes: gender-related
differences. Arquivos Brasileiros de Cardiologia. 2005;
Parashar S, Rumsfeld JS, Spertus JA, Reid KJ, Wenger
NK, Krumholz HM, Amin A, Weintraub WS, Lichtman
J, Dawood N, Vaccarino V. Time course of depression and
outcome of myocardial infarction. Archives of Internal
Medicine. 2006; 166(18):2035–43.
Dias CC, Mateus PS, Mateus C, Bettencourt N, Santos L,
Adao L, Sampaio F, Fonseca C, Simões L, Coelho R, Ribeiro
VG. Acute coronary syndrome and depression. Revista
portuguesa de cardiologia: orgao oficial da Sociedade Portuguesa
de Cardiologia=Portuguese journal of cardiology:
an official Journal of the Portuguese Society of Cardiology.
Gholizadeh L. Cross-cultural validation of the Cardiac Depression
Scale in Iran. Br J Clin Psychol. 2010; 49(4):517–
Eng HS, Yean LC, Das S, Letchmi S, Yee KS, Bakar RA,
Hung J, Choy CY. Anxiety and depression in patients with
coronary heart disease: a study in a tertiary hospital. Iranian
Journal of Medical Sciences. 2011; 36(3):201–6.
Moraska AR, Chamberlain AM, Shah ND, Vickers KS,
Rummans TA, Dunlay SM, Spertus JA, Weston SA, McNallan
SM, Redfield MM, Roger VL. Depression, healthcare
utilization, and death in heart failure a community study.
Circulation: Heart Failure. 2013 May 1; 6(3):387–94.
Blumenthal JA, Lett HS, Babyak MA, White W, Smith
PK, Mark DB, Jones R, Mathew JP, Newman MF, NORG
Investigators. Depression as a risk factor for mortality
after coronary artery bypass surgery. The Lancet. 2003;
Mann DL, Zipes DP, Libby P, Bonow RO. Braunwald’s heart
disease: a textbook of cardiovascular medicine. Philadelphia,
US: Elsevier Health Sciences; 2014 Jul 30.
Druss BG, Bradford DW, Rosenheck RA, Radford MJ,
Krumholz HM. Mental disorders and use of cardiovascular
procedures after myocardial infarction. JAMA. 2000;
Safaie N, Jodati AR, Raoofi M, Khalili M. Depression in
Coronary Artery Disease. Journal of Cardiovascular and
Thoracic Research. 2012; 4(3):77.
Shokrgozar S, Ahmadi R, Khairkhah J, Moorosi M. Severity
of Depression in Hospitalized Patients with Cardiovascular
Diseases by Cardiac Depression Scale (CDS). Journal of
Guilan University of Medical Sciences. 2015; 24(2):9–15.
- There are currently no refbacks.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License.
Listed as Green Publisher
Powered by Informatics India Ltd