ABSTRACT
OBJECTIVE: Many peri-myocardial infarction patients experience decreased wellbeing, which is either conceptualized as depression or as vital exhaustion. The objective of the present study is to investigate whether or not depression and vital exhaustion are separate entities. It was hypothesized that, if depression and vital exhaustion are separate phenomena, the correlation between two depression questionnaires would be higher than those between either of the two depression questionnaires and a vital exhaustion questionnaire. METHOD: Subjects were 143 patients who had recently experienced a first acute myocardial infarction (MI). At 1, 3, 6 and 12 months post-MI, patients completed two self-report depression questionnaires (the Zung-SDS and the Depression scale of the SCL-90), and a vital exhaustion questionnaire (the Maastricht Questionnaire). Correlation coefficients were calculated for the two depression questionnaires and the vital exhaustion questionnaire. Furthermore, an exploratory principal component analysis was performed on the combined items of the three questionnaires. RESULTS: Strong and virtually identical correlations were found between the three measures at all four time-points. A one-factor model was the best fit in the exploratory principal component analysis. CONCLUSION: The present results do not support the hypothesized separate conceptual identity of depression and vital exhaustion.
Subject(s)
Depression/etiology , Fatigue/etiology , Myocardial Infarction/complications , Adult , Aged , Depression/diagnosis , Diagnosis, Differential , Factor Analysis, Statistical , Fatigue/diagnosis , Female , Follow-Up Studies , Humans , Male , Middle Aged , Models, Psychological , Myocardial Infarction/physiopathology , Myocardial Infarction/psychology , Prospective Studies , Surveys and QuestionnairesABSTRACT
OBJECTIVE: To determine frequency and clinical features of major depressive disorder according to DSM IV criteria in patients following a first myocardial infarction. DESIGN: Questionnaire. SETTING: Departments of Cardiology and Psychiatry, University Hospital Maastricht, the Netherlands. METHOD: Depression was assessed using the Zung 'Self-rating depression scale' (Zung-SDS) and the 'Symptom checklist' (SCL)-90 in 228 patients who filled the questionnaires out themselves (response: 60-70%), 1, 3, 6 en 12 months after their first heart attack. When the score on one or both lists was above threshold, the patient was invited for a clinical interview with a psychiatrist. RESULTS: One month post infarction 10% were diagnosed with a major depressive episode, a percentage which increased to 34% one year post infarction. The clinical features of the depression in these patients were the same as in a matched sample of depressed psychiatric inpatients without a cardiac history, except that hostility was significantly increased in the post-infarction patients. There was no mortality. CONCLUSION: Depressive disorder is a frequent comorbid disease after a first myocardial infarction.
