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Mortality and Quality of Life 12 Months After Myocardial Infarction: Effects of Depression and Anxiety

Lane, Deirdre PhD; Carroll, Douglas PhD, FBPsS, CPsychol; Ring, Christopher PhD, AFBPsS, CPsychol; Beevers, D. Gareth MD, FRCP, and; Lip, Gregory Y. H. MD, FRCP, FACC, FESC


Objective The purpose of this study was to determine the impact of symptoms of depression and anxiety on mortality and quality of life in patients hospitalized for acute myocardial infarction (MI).

Methods The Beck Depression Inventory and the State-Trait Anxiety Inventory were completed by 288 patients hospitalized for MI. Twelve-month survival status was ascertained, and quality of life among survivors was assessed at 12 months using the Dartmouth COOP charts.

Results Thirty-one (10.8%) patients died, 27 of cardiac causes, during the 12-month follow-up. Symptoms of depression and anxiety predicted neither cardiac nor all-cause mortality. Severity of infarction and evidence of heart failure predicted both cardiac and all-cause mortality. The same findings emerged from supplementary analyses of data from patients who died after discharge from the hospital. Symptoms of depression and anxiety, measured at entry, predicted 12-month quality of life among survivors, as did gender, partner status, employment status, living alone, previous frequency of exercise, and indices of disease severity (Killip class and Peel Index). In a multiple regression model in which all of these variables were entered, initial depression scores provided the best independent prediction of quality of life, although living alone, severity of infarction, and state anxiety also entered the model.

Conclusions Symptoms of depression and anxiety did not predict either cardiac or all-cause mortality after MI, but they did predict quality of life among those who lived to 12 months.

From the University of Birmingham, Birmingham, United Kingdom.

Address reprint requests to: Douglas Carroll, PhD, FBPsS, CPsychol, School of Sport and Exercise Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. Email: carrolld@

Received for publication February 2, 2000; revision received June 13, 2000.

Copyright © 2001 by American Psychosomatic Society
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