Predictors of depression 12 months after cardiac hospitalization: the Identifying Depression as a Comorbid Condition study

Abstract

Objective: To determine characteristics which predict depression at 12 months after cardiac hospitalization, and track the natural history of depression. Method: Depressive symptoms were monitored at baseline, 3 and 12 months in a cohort of 785 patients, using the self-report Center for Epidemiological Studies Depression Scale. Multinomial regression analyses of baseline clinical and demographic variables identified characteristics associated with depression at 12 months. Results: Three baseline variables predicted moderate to severe depression at 12 months: depression during index admission, past history of emotional health problems and current smoking. For those who were depressed during cardiac hospitalization, 51% remained depressed at both 3 and 12 months. Persistence was more evident in patients who had moderate to severe depressive symptoms when hospitalized. Mild depression was as likely to persist as to remit. Conclusions: Three clinically accessible characteristics at the time of cardiac hospitalization can assist in predicting depression at 12 months and may aid treatment decisions. Depressive symptoms persist in a substantial proportion of cardiac patients up to 12 months after hospitalization. Key words: depression, heart disease, inpatient, natural history, predictor.