Depression and anxiety following myocardial infarction and their inverse associations with future health behaviors and quality of life

Background Post-myocardial infarction (MI) depression and anxiety were found to predict prognosis and quality of life. Purpose The purpose of this study was to test a behavioral pathway from post-MI depression/anxiety to future quality of life. Methods This is a longitudinal cohort study. Five hundred forty patients (≤65 years old) filled out questionnaires after a first MI, including socio-demographics, pre-MI health status and behaviors, MI severity, social support, sense of coherence, depression, and anxiety. Reports of health behaviors were obtained 5 years and of quality of life 10 years later. Results A structural equations model confirmed that depression and anxiety were directly related to poorer quality of life 10 years later. These relationships were partly mediated by a positive association between anxiety and health behaviors at 5 years and a negative one between depression and health behaviors. Conclusions The opposite effects of anxiety and depression underscore the need to attend to both emotional reactions to MI while encouraging preventive health behaviors.