Universität zu Köln

Vitinius, Frank, Escherich, Steffen, Deter, Hans-Christian, Hellmich, Martin, Juenger, Jana, Petrowski, Katja, Ladwig, Karl-Heinz, Lambertus, Frank, Michal, Matthias, Weber, Cora, de Zwaan, Martina, Herrmann-Lingen, Christoph, Ronel, Joram and Albus, Christian (2019). Somatic and sociodemographic predictors of depression outcome among depressed patients with coronary artery disease - a secondary analysis of the SPIRR-CAD study. BMC Psychiatry, 19. LONDON: BMC. ISSN 1471-244X

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Abstract

BackgroundDepressive symptoms are common in patients with coronary artery disease (CAD) and are associated with an unfavourable outcome. Establishing prognostic patient profiles prior to the beginning of mental health care may facilitate higher efficacy of targeted interventions. The aim of the current study was to identify sociodemographic and somatic predictors of depression outcome among depressed patients with CAD.MethodsBased on the dataset of the multicentre SPIRR-CAD randomised controlled trial (n=570 patients with CAD and8 points on the Hospital Anxiety and Depression Scale (HADS)), 141 potential sociodemographic and somatic predictors of the change in the HADS-D depression score from baseline to 18-month-follow-up were derived in two different ways. We screened for univariable association with response, using either analysis of (co)variance or logistic regression, respectively, both adjusted for baseline HADS-D value and treatment group. To guard against overfitting, multivariable association was evaluated by a linear or binomial (generalised) linear model with lasso regularisation, a machine learning approach. Outcome measures were the change in continuous HADS-D depression scores, as well as three established binary criteria. The Charlson Comorbidity Index (CCI) was calculated to assess possible influences of comorbidities on our results and was also entered in our machine learning approach.ResultsHigher age (p=0.002), unknown previous myocardial infarction (p=0.013), and a higher heart rate variability during numeracy tests (p=.020) were univariably associated with a favourable depression outcome, whereas hyperuricemia (p0.003), higher triglycerides (p=0.014), NYHA class III (p0.028), state after resuscitation (p0.042), intake of thyroid hormones (p=0.007), antidiabetic drugs (p=0.015), analgesic drugs (p=0.027), beta blockers (p=0.035), uric acid drugs (p0.039), and anticholinergic drugs (p=0.045) were associated with an adverse effect on the HADS-D depression score. In all analyses, no significant differences between study arms could be found and physical comorbidities also had no significant influence on our results.ConclusionOur findings may contribute to identification of somatic and sociodemographic predictors of depression outcome in patients with CAD. The unexpected effects of specific medication require further clarification and further research is needed to establish a causal association between depression outcome and our predictors.Trial registrationwww.clinicaltrials.govNCT00705965 (registered 27th of June, 2008).www.isrctn.comISRCTN76240576 (registered 27th of March, 2008).

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Vitinius, Frank UNSPECIFIED UNSPECIFIED UNSPECIFIED Escherich, Steffen UNSPECIFIED UNSPECIFIED UNSPECIFIED Deter, Hans-Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Hellmich, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Juenger, Jana UNSPECIFIED UNSPECIFIED UNSPECIFIED Petrowski, Katja UNSPECIFIED UNSPECIFIED UNSPECIFIED Ladwig, Karl-Heinz UNSPECIFIED UNSPECIFIED UNSPECIFIED Lambertus, Frank UNSPECIFIED UNSPECIFIED UNSPECIFIED Michal, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Weber, Cora UNSPECIFIED UNSPECIFIED UNSPECIFIED de Zwaan, Martina UNSPECIFIED UNSPECIFIED UNSPECIFIED Herrmann-Lingen, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Ronel, Joram UNSPECIFIED UNSPECIFIED UNSPECIFIED Albus, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-156996
DOI:	10.1186/s12888-019-2026-6
Journal or Publication Title:	BMC Psychiatry
Volume:	19
Date:	2019
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1471-244X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language STEPWISE PSYCHOTHERAPY INTERVENTION; ACUTE MYOCARDIAL-INFARCTION; HEART-RATE-VARIABILITY; URIC-ACID LEVELS; QUALITY-OF-LIFE; PROGNOSTIC ASSOCIATION; CARDIOVASCULAR EVENTS; MAJOR DEPRESSION; RANDOMIZED-TRIAL; REDUCING RISK Multiple languages Psychiatry Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/15699