Relationship between depressive symptoms and quality of life in patients with coronary artery disease before and after percutaneus coronary interventions
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Arch Psych Psych 2007;9(3):71–78
Introduction: Studies have shown that successful percutaneous coronary interventions (PCI) in coronary artery disease patients are associated with significant improvement in quality of life (QOL). However, this notion has been challenged by reports of some discrepancy between the cardiological outcome of PCI and QOL improvement. Aim: to assess the relationship between depressive symptoms and the QOL in CAD patients after successful PCI. Subjects and methods: Of 227 CAD patients, qualified for PCI, 156 with optimal PCI result were included. Patients were assessed one day prior, then 1 month, 6 months and 1 year after PCI, using the Polish version of the SF-36 questionnaire, the Beck Depression Inventory and the Hamilton Depression Rating Scale. Results: In the entire study group QOL as measured 1 month after PTCA indicated significant improvement. This tendency persisted in subsequent examinations. The presence of depressive disorders recorded one day prior to PCI served as a basis to identify group I (n=75) - patients with depressive disorders before PCI and II (n=81) - patients without depressive symptoms. On each occasion QOL in group I was significantly poorer than in group II, both with respect to the total QOL and individual components measured by 8 subscales of the SF-36. There was a significant correlation between QOL and severity of depressive symptoms. Conclusions: The present findings indicate that depressive disorders in patients with CAD - even after successful intervention - significantly affect the QOL. Successful intervention and restoration of coronary arteries are not the only determinants of satisfactory improvement in the QOL of cardiac patients.