To assess the association of baseline anxiety
persistence and change in depressive symptoms 6 months after cardiac hospitalization.
Data were analyzed from 137 depressed patients hospitalized on inpatient cardiac units for acute coronary syndrome, decompensated heart failure
, or arrhythmia and who were enrolled in a randomized trial of collaborative care depression
management. Subjects’ demographic, medical, and psychiatric information at baseline was compiled. Measures of health-related quality of life, cardiac symptoms, and psychiatric symptoms, including the Hospital Anxiety
subscale (HADS-A) for anxiety
, were obtained at baseline and serially during a 6-month follow-up period. The association between baseline HADS-A score and depression
persistence (<50% reduction in depressive symptoms on the Patient Health Questionnaire-9) at 6 months was assessed by multivariate logistic regression accounting for the effects of multiple relevant medical and psychological covariates. The association between baseline HADS-A score and improvement in depressive symptoms (Patient Health Questionnaire-9) from baseline at 6 months was assessed by linear regression accounting for the same covariates.
Baseline HADS-A score was independently associated with depression
persistence at 6 months (odds ratio = 1.11, 95% confidence interval = 1.01–1.22, p
= .03). Likewise, higher baseline HADS-A score was associated with less improvement in depressive symptoms at 6 months (β = −0.34, p
Among a cohort of depressed cardiac patients, higher baseline anxiety
score was linked with lesser improvement in depressive symptoms and increased likelihood of depression
persistence at 6 months, independent of multiple relevant covariates. Trial Registration
: clinicaltrials.gov Identifier: NCT00847132.
= Massachusetts General Hospital Cognitive and Physical Functioning Questionnaire; HADS-A
= Hospital Anxiety
= heart failure
= health-related quality of life; MI
= myocardial infarction
= Patient Health Questionnaire-9; SF-12 MCS
= Medical Outcomes Study 12-item Short-Form—mental component score; SF-12 PCS
= Medical Outcomes Study 12-item Short-Form—physical component score