Prognostic Value of Depression, Anxiety, and Anger in Hospitalized Cardiovascular Disease Patients for Predicting Adverse Cardiac Outcomes
Although attention has recently been focused on the role of psychosocial factors in patients with cardiovascular disease (CVD), the factors that have the greatest influence on prognosis have not yet been elucidated. The aim of this study was to evaluate the effects of depression, anxiety, and anger...
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| Veröffentlicht in: | The American journal of cardiology 2013-05, Vol.111 (10), p.1432-1436 |
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| creator | Nakamura, Shunichi, MD Kato, Koji, MD, PhD Yoshida, Asuka, MD Fukuma, Nagaharu, MD, PhD Okumura, Yasuyuki, PhD Ito, Hiroto, PhD Mizuno, Kyoichi, MD, PhD |
| description | Although attention has recently been focused on the role of psychosocial factors in patients with cardiovascular disease (CVD), the factors that have the greatest influence on prognosis have not yet been elucidated. The aim of this study was to evaluate the effects of depression, anxiety, and anger on the prognosis of patients with CVD. Four hundred fourteen consecutive patients hospitalized with CVD were prospectively enrolled. Depression was evaluated using the Patient Health Questionnaire, anxiety using the Generalized Anxiety Disorder Questionnaire, and anger using the Spielberger Trait Anger Scale. Cox proportional-hazards regression was used to examine the individual effects of depression, anxiety, and anger on a combined primary end point of cardiac death or cardiac hospitalization and on a combined secondary end point of all-cause death or hospitalization during follow-up (median 14.2 months). Multivariate analysis showed that depression was a significant risk factor for cardiovascular hospitalization or death after adjusting for cardiac risk factors and other psychosocial factors (hazard ratio 2.62, p = 0.02), whereas anxiety was not significantly associated with cardiovascular hospitalization or death after adjustment (hazard ratio 2.35, p = 0.10). Anger was associated with a low rate of cardiovascular hospitalization or death (hazard ratio 0.34, p |
| doi_str_mv | 10.1016/j.amjcard.2013.01.293 |
| format | Article |
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The aim of this study was to evaluate the effects of depression, anxiety, and anger on the prognosis of patients with CVD. Four hundred fourteen consecutive patients hospitalized with CVD were prospectively enrolled. Depression was evaluated using the Patient Health Questionnaire, anxiety using the Generalized Anxiety Disorder Questionnaire, and anger using the Spielberger Trait Anger Scale. Cox proportional-hazards regression was used to examine the individual effects of depression, anxiety, and anger on a combined primary end point of cardiac death or cardiac hospitalization and on a combined secondary end point of all-cause death or hospitalization during follow-up (median 14.2 months). Multivariate analysis showed that depression was a significant risk factor for cardiovascular hospitalization or death after adjusting for cardiac risk factors and other psychosocial factors (hazard ratio 2.62, p = 0.02), whereas anxiety was not significantly associated with cardiovascular hospitalization or death after adjustment (hazard ratio 2.35, p = 0.10). Anger was associated with a low rate of cardiovascular hospitalization or death (hazard ratio 0.34, p <0.01). In conclusion, depression in hospitalized patients with CVD is a stronger independent risk factor for adverse cardiac events than either anxiety or anger. Anger may help prevent adverse outcomes. Routine screening for depression should therefore be performed in patients with CVD, and the potential effects of anger in clinical practice should be reconsidered.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2013.01.293</identifier><identifier>PMID: 23433760</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Anger ; Anxiety ; Anxiety - complications ; Anxiety - epidemiology ; Anxiety - psychology ; Cardiovascular ; Cardiovascular disease ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - etiology ; Cardiovascular Diseases - psychology ; Cause of Death - trends ; Cholesterol ; Depression - complications ; Depression - epidemiology ; Depression - psychology ; Female ; Follow-Up Studies ; Heart attacks ; Heart failure ; Hospitalization ; Humans ; Incidence ; Japan - epidemiology ; Male ; Middle Aged ; Prognosis ; Prospective Studies ; Risk Factors ; Surveys and Questionnaires</subject><ispartof>The American journal of cardiology, 2013-05, Vol.111 (10), p.1432-1436</ispartof><rights>Elsevier Inc.</rights><rights>2013 Elsevier Inc.</rights><rights>Copyright © 2013 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited May 15, 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c514t-576df75803104affcef1fd58f8d7ca96d3ad15b444a1c0982b2f18c3a5ee24873</citedby><cites>FETCH-LOGICAL-c514t-576df75803104affcef1fd58f8d7ca96d3ad15b444a1c0982b2f18c3a5ee24873</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1347357658?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>315,781,785,3551,27928,27929,45999,64389,64391,64393,72473</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23433760$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nakamura, Shunichi, MD</creatorcontrib><creatorcontrib>Kato, Koji, MD, PhD</creatorcontrib><creatorcontrib>Yoshida, Asuka, MD</creatorcontrib><creatorcontrib>Fukuma, Nagaharu, MD, PhD</creatorcontrib><creatorcontrib>Okumura, Yasuyuki, PhD</creatorcontrib><creatorcontrib>Ito, Hiroto, PhD</creatorcontrib><creatorcontrib>Mizuno, Kyoichi, MD, PhD</creatorcontrib><title>Prognostic Value of Depression, Anxiety, and Anger in Hospitalized Cardiovascular Disease Patients for Predicting Adverse Cardiac Outcomes</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Although attention has recently been focused on the role of psychosocial factors in patients with cardiovascular disease (CVD), the factors that have the greatest influence on prognosis have not yet been elucidated. The aim of this study was to evaluate the effects of depression, anxiety, and anger on the prognosis of patients with CVD. Four hundred fourteen consecutive patients hospitalized with CVD were prospectively enrolled. Depression was evaluated using the Patient Health Questionnaire, anxiety using the Generalized Anxiety Disorder Questionnaire, and anger using the Spielberger Trait Anger Scale. Cox proportional-hazards regression was used to examine the individual effects of depression, anxiety, and anger on a combined primary end point of cardiac death or cardiac hospitalization and on a combined secondary end point of all-cause death or hospitalization during follow-up (median 14.2 months). Multivariate analysis showed that depression was a significant risk factor for cardiovascular hospitalization or death after adjusting for cardiac risk factors and other psychosocial factors (hazard ratio 2.62, p = 0.02), whereas anxiety was not significantly associated with cardiovascular hospitalization or death after adjustment (hazard ratio 2.35, p = 0.10). Anger was associated with a low rate of cardiovascular hospitalization or death (hazard ratio 0.34, p <0.01). In conclusion, depression in hospitalized patients with CVD is a stronger independent risk factor for adverse cardiac events than either anxiety or anger. Anger may help prevent adverse outcomes. Routine screening for depression should therefore be performed in patients with CVD, and the potential effects of anger in clinical practice should be reconsidered.</description><subject>Aged</subject><subject>Anger</subject><subject>Anxiety</subject><subject>Anxiety - complications</subject><subject>Anxiety - epidemiology</subject><subject>Anxiety - psychology</subject><subject>Cardiovascular</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular Diseases - epidemiology</subject><subject>Cardiovascular Diseases - etiology</subject><subject>Cardiovascular Diseases - psychology</subject><subject>Cause of Death - trends</subject><subject>Cholesterol</subject><subject>Depression - complications</subject><subject>Depression - epidemiology</subject><subject>Depression - psychology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart attacks</subject><subject>Heart failure</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Incidence</subject><subject>Japan - epidemiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Surveys and Questionnaires</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkt1u1DAQhSMEokvhEUCWuOGiCZ44zs8NaLUFilSpK_Fza3nt8cohibd2smL7CH1qHHYBqTdcWSN_czw-Z5LkJdAMKJRv20z2rZJeZzkFllHI8oY9ShZQV00KDbDHyYJSmqcNFM1Z8iyENpYAvHyanOWsYKwq6SK5X3u3HVwYrSLfZTchcYZc4s5jCNYNF2Q5_LQ4Hi6IHHQstuiJHciVCzs7ys7eoSarOIV1exnU1ElPLm1AGZCs5WhxGAMxzpO1R23VaIctWeo9-nj_u00qcjONyvUYnidPjOwCvjid58m3jx--rq7S65tPn1fL61RxKMaUV6U2Fa8pA1pIYxQaMJrXptaVkk2pmdTAN0VRSFC0qfNNbqBWTHLEvKgrdp68OeruvLudMIyit0Fh18kB3RQEsKLmNC-hjOjrB2jrJj_E6WaqYnEWXkeKHynlXQgejdh520t_EEDFHJZoxSksMYclKIgYVux7dVKfNj3qv11_0onA-yOA0Y69RS-CipaqaKVHNQrt7H-fePdAQXV2sEp2P_CA4d9vRMgFFV_mjZkXBhilrG44-wUMx74k</recordid><startdate>20130515</startdate><enddate>20130515</enddate><creator>Nakamura, Shunichi, MD</creator><creator>Kato, Koji, MD, PhD</creator><creator>Yoshida, Asuka, MD</creator><creator>Fukuma, Nagaharu, MD, PhD</creator><creator>Okumura, Yasuyuki, PhD</creator><creator>Ito, Hiroto, PhD</creator><creator>Mizuno, Kyoichi, MD, PhD</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7Z</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20130515</creationdate><title>Prognostic Value of Depression, Anxiety, and Anger in Hospitalized Cardiovascular Disease Patients for Predicting Adverse Cardiac Outcomes</title><author>Nakamura, Shunichi, MD ; Kato, Koji, MD, PhD ; Yoshida, Asuka, MD ; Fukuma, Nagaharu, MD, PhD ; Okumura, Yasuyuki, PhD ; Ito, Hiroto, PhD ; Mizuno, Kyoichi, MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c514t-576df75803104affcef1fd58f8d7ca96d3ad15b444a1c0982b2f18c3a5ee24873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Anger</topic><topic>Anxiety</topic><topic>Anxiety - 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Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nakamura, Shunichi, MD</au><au>Kato, Koji, MD, PhD</au><au>Yoshida, Asuka, MD</au><au>Fukuma, Nagaharu, MD, PhD</au><au>Okumura, Yasuyuki, PhD</au><au>Ito, Hiroto, PhD</au><au>Mizuno, Kyoichi, MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic Value of Depression, Anxiety, and Anger in Hospitalized Cardiovascular Disease Patients for Predicting Adverse Cardiac Outcomes</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2013-05-15</date><risdate>2013</risdate><volume>111</volume><issue>10</issue><spage>1432</spage><epage>1436</epage><pages>1432-1436</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>Although attention has recently been focused on the role of psychosocial factors in patients with cardiovascular disease (CVD), the factors that have the greatest influence on prognosis have not yet been elucidated. The aim of this study was to evaluate the effects of depression, anxiety, and anger on the prognosis of patients with CVD. Four hundred fourteen consecutive patients hospitalized with CVD were prospectively enrolled. Depression was evaluated using the Patient Health Questionnaire, anxiety using the Generalized Anxiety Disorder Questionnaire, and anger using the Spielberger Trait Anger Scale. Cox proportional-hazards regression was used to examine the individual effects of depression, anxiety, and anger on a combined primary end point of cardiac death or cardiac hospitalization and on a combined secondary end point of all-cause death or hospitalization during follow-up (median 14.2 months). Multivariate analysis showed that depression was a significant risk factor for cardiovascular hospitalization or death after adjusting for cardiac risk factors and other psychosocial factors (hazard ratio 2.62, p = 0.02), whereas anxiety was not significantly associated with cardiovascular hospitalization or death after adjustment (hazard ratio 2.35, p = 0.10). Anger was associated with a low rate of cardiovascular hospitalization or death (hazard ratio 0.34, p <0.01). In conclusion, depression in hospitalized patients with CVD is a stronger independent risk factor for adverse cardiac events than either anxiety or anger. Anger may help prevent adverse outcomes. Routine screening for depression should therefore be performed in patients with CVD, and the potential effects of anger in clinical practice should be reconsidered.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>23433760</pmid><doi>10.1016/j.amjcard.2013.01.293</doi><tpages>5</tpages></addata></record> |
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| subjects | Aged Anger Anxiety Anxiety - complications Anxiety - epidemiology Anxiety - psychology Cardiovascular Cardiovascular disease Cardiovascular Diseases - epidemiology Cardiovascular Diseases - etiology Cardiovascular Diseases - psychology Cause of Death - trends Cholesterol Depression - complications Depression - epidemiology Depression - psychology Female Follow-Up Studies Heart attacks Heart failure Hospitalization Humans Incidence Japan - epidemiology Male Middle Aged Prognosis Prospective Studies Risk Factors Surveys and Questionnaires |
| title | Prognostic Value of Depression, Anxiety, and Anger in Hospitalized Cardiovascular Disease Patients for Predicting Adverse Cardiac Outcomes |
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