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Problems living alone can predict development of depression in CHD patients

Problems living alone, chest pain and disability are important predictors of depression in patients with coronary heart disease, suggests a recent UK study.

803 patients, with a mean age of 71 years, with coronary heart disease were recruited from general practice registers and assessed for cardiac symptoms, depression, quality of life and social problems over a two-year period. Depression was measured using the Clinical Interview Schedule-Revised, which yielded an International Classification of Diseases-10 (ICD-10). Quality of life was measured using the EQ-5D and current social problems using the Social Problem Questionnaire (SQP).

42% of the participants had a documented history of myocardial infarction, and 54% had a diagnosis of ischaemic heart disease or angina. 44% of the participants still experienced chest pain. 7% of participants had an ICD-10 defined depressive disorder. Factors independently associated with this diagnosis were problems living alone (3.71), experiencing chest pain (3.27) and other pains or discomfort (3.39). The social problems at baseline that affected the risk for a depressive disorder were problems with usual activity (5.96), problems with pain or discomfort (5.96), problems living alone (8.73) and lack of social contacts (4.13)

The researchers noted that the ‘coronary heart disease register was shown to be an effective means to assess a community population with documented coronary heart disease’ and advised that ‘the follow-up of these study participants will allow associations to be tested in a more substantial way’.

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