The evolution of depressive symptoms in coronary artery disease patients after successful coronary angioplasty
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Psychiatr Pol 2007;41(2):217-227
Aim. The aim of the study was to investigate the spectrum and course of depressive symptoms in cardiac ischemic disease (CAD) patients before and after successful coronary angioplasty (PCI) in one year follow-up. Method. 227 patients with CAD selected for PTCA were enrolled. 156 patients with full clinical and angiographic success and without restenosis within 4 weeks after the intervention were included in further analysis. Patients' status was assessed four times (one day before and at 1, 6 and 12 months after the intervention), with Beck's Depression Inventory (BDI), Rosenberg's Self-Esteem Scale (RS), Beck's Hopelessness Scale (HS), Automatic Thoughts Questionnaire (ATQ). Results. Mild and moderate depressive disorders with the prevalence of non-specific somatic symptoms were observed one day before PTCA in 75 (48%) patients. One month after the PCI, depressive symptoms persisted in 33 subjects. Moreover in the group of patients who were free of depressive symptoms a day before PTCA, twelve patients (15%) developed depressive symptomatology. Depressive symptoms and depressive disorders of thinking (especially hopelessness) recognized 4 weeks after PTCA had a tendency to persist at 6 and 12 months. The tendency was associated with more severe affective-cognitive and somatic symptoms of the depressive syndrome, more frequent negative automatic thoughts and stronger hopelessness detected at the beginning of the study. Conclusions. The results of the study suggest that successful PCI is not a sufficient determinant for the improvement of depressive symptoms. Diagnosis of depression in CAD patients needs special attention, because of a tendency to persist.
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