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Trajectories and predictors of anxiety and depression in women during the 12 months following an acute cardiac event

journal contribution
posted on 2008-02-01, 00:00 authored by B M Murphy, P C Elliott, M U C Worcester, R O Higgins, Michael Le GrandeMichael Le Grande, S B Roberts, A J Goble
Objectives. Many previous investigations of the recovery of emotional well-being, particularly the resolution of depression, following an acute cardiac event assume that all patients follow a similar, linear trajectory. However, it is possible that there are different groups of patients who follow different trajectories. This study tested for multiple trajectories of anxiety and depression and identified the characteristics of patients most at risk for persistent or worsening anxiety and depression in the 12 months following their cardiac event. Method. A consecutive sample of 226 women was interviewed following either acute myocardial infarction (AMI) or coronary artery bypass graft surgery (CABGS). The Hospital Anxiety and Depression Scale were administered on four occasions over 12 months. Growth curve and growth mixture modelling were used to identify trajectories of change and univariate tests were employed to establish predictors of each trajectory. Results. Most women began with relatively low levels of anxiety and/or depression that improved over the 12 month period (84% women showed this trajectory for anxiety, 89% for depression). A smaller group began with relatively high levels of anxiety and/or depression that worsened over time (16% for anxiety, 11% for depression). Patients in the latter group were more likely to report high levels of loneliness, have a first language other than English, perceive their cardiac disease as more severe (anxiety group only) and have diabetes (depression group only). Trajectories were non-linear, with most change occurring in the initial 2-month period. Conclusion. Growth modelling techniques highlight that change in anxiety and depression following an acute event follows neither a single nor linear trajectory. Most women showed early resolution of anxiety and depression following their event, indicative of a normal bereavement or adjustment response. A minority of women reported worsening anxiety and/or depression in the year following their cardiac event, particularly those who lacked social support or were from non-English speaking backgrounds. Intervention studies to explore support options for these women are warranted, both prior to and following their event. © 2008 The British Psychological Society.

History

Journal

British Journal of Health Psychology

Volume

13

Issue

1

Pagination

135 - 153

ISSN

1359-107X

Publication classification

C1.1 Refereed article in a scholarly journal