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Contribution of depression and anxiety to impaired health-related quality of life following first myocardial infarction

Department of Psychiatry, Manchester University, UK

B. TOMENSON, MSc, L. COTTER, MD and A. HEAGERTY, MD

Department of Cardiology, Manchester Royal Infirmary, UK

F. H. CREED, MD

Department of Psychiatry, Manchester University, UK

Correspondence: Chris Dickens, Department of Psychiatry, Rawnsley Building, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK. Tel: +44 (0)161 276 5386; fax: +44 (0)161 273 2135; email: chris.dickens{at}manchester.ac.uk

Declaration of interest F.H.C. has performed consultancy work for Ely Lilly in a field unconnected with the current study. There are no other conflicts of interest to declare.

Background The extent to which depression impairs health-related quality of life (HRQoL) in the physically ill has not been clearly established.

Aims To quantify the adverse influence of depression and anxiety, assessed at the time of first myocardial infarction and 6 months later, on the physical aspect of HRQoL 12 months after the infarction.

Method In all, 260 in-patients, admitted following first myocardial infarction, completed the Hospital Anxiety and Depression Scale and the Medical Outcomes Study SF–36 assessment before discharge and at 6- and 12-month follow-up.

Results Depression and anxiety 6 months after myocardial infarction predicted subsequent impairment in the physical aspects of HRQoL (attributable adjusted R²=9%, P<0.0005). These negative effects of depression and anxiety on outcome were mediated by feelings of fatigue. Depression and anxiety present before myocardial infarction did not predict HRQoL 12 months after myocardial infarction.

Conclusions Detection and treatment of depression and anxiety following myocardial infarction improve the patient’s health-related quality of life.

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