(Circulation. 2000;101:1919.)
© 2000 American Heart Association, Inc.
Clinical Investigation and Reports |
Social Support, Depression, and Mortality During the First Year After Myocardial Infarction
Presented in part at the American Psychosomatic Society Meeting, Vancouver, Canada, March 1999.
From the Departments of Psychiatry (N.F.-S., F.L.) and School of Nursing (N.F.-S), McGill University; the Research Center, Montreal Heart Institute (N.F.-S., F.L., G.G., A.M., M.J., M.T., M.G.B.); and the Departments of Psychiatry (N.F.-S., F.L.) and Medicine (M.J., M.T., M.G.B.), University of Montreal. Montreal, Canada.
Correspondence to Nancy Frasure-Smith, Research Center, Montreal Heart Institute, 5000 Belanger St E, Montreal, Quebec, Canada, H1T 1C8. E-mail frsm{at}icm.umontreal.ca
Background—We previously reported that depression after myocardial infarction (MI) increases the long-term risk of cardiac mortality. Other research suggests that social support may also influence prognosis. This article examines the interrelationships between baseline depression and social support in terms of cardiac prognosis and changes in depression symptoms over the first post-MI year.
Methods and Results—For this study, 887 patients completed the
Beck Depression Inventory (BDI) and the Perceived Social Support Scale
(PSSS) at about 7 days after MI. Some 32% had BDIs 
10, indicating
mild to moderate depression. One-year survival status was determined
for all patients. Follow-up interviews, including the BDI, were
conducted with 89% of survivors. There were 39 deaths (35 cardiac).
Elevated BDI scores were related to cardiac mortality
(P=0.0006), but PSSS scores and other measures of social
support were not. There was a significant interaction between
depression and the PSSS (P=0.016). The relationship
between depression and cardiac mortality decreased with increasing
support. Furthermore, residual change score analysis revealed
that among 1-year survivors who had been depressed at baseline, higher
baseline social support was related to more improvement in depression
symptoms than expected.
Conclusions—Post-MI depression is a predictor of 1-year cardiac mortality, but social support is not directly related to survival. However, very high levels of support appear to buffer the impact of depression on mortality. Furthermore, high levels of support predict improvements in depression symptoms over the first post-MI year in depressed patients. High levels of support may protect patients from the negative prognostic consequences of depression because of improvements in depression symptoms.
Key Words: myocardial infarction • depression • social support • prognosis
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|
|
|
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|
|
|
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|
|
|
|
 |
|
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|
|
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|
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|
|
|
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|
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|
|
|
|
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|
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|
|
|
|
|
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|
|
|
|
 |
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|
|
|
|
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|
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|
|
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|
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|
|
|
|
|
|
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|
|
|
|
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|
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|
|