TY - JOUR
T1 - Severity of Depressive Symptoms Pre-and Postcardiac Rehabilitation
T2 - A COMPARISON among PATIENTS in Brazil, CANADA, COLOMBIA, the UNITED STATES, and VENEZUELA
AU - Ghisi, Gabriela Lima De Melo
AU - Santos, Claudia Victoria Anchique
AU - Benaim, Briseida
AU - Lopez-Jimenez, Francisco
AU - Herdy, Artur Haddad
AU - Inojosa, Jose Medina
AU - Terzic, Carmen M.
AU - Janovik, Lisiane
AU - Rojas, Maria Fernanda
AU - Grace, Sherry L.
N1 - Publisher Copyright:
© 2017 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2017/5/1
Y1 - 2017/5/1
N2 - PURPOSE: Depression is 3 times more prevalent in the cardiac than the general population in high-income countries and is particularly high in middle-income countries. Comorbid depression is associated with twice the mortality after a cardiovascular event. The objectives of this study were to describe and compare depressive symptoms pre-and postcardiac rehabilitation (CR) among patients in high-income countries and middle-income countries in the Americas. METHODS: The study design was prospective and observational. A convenience sample of CR participants completed the Patient Health Questionnaire-9 (PHQ-9) at CR intake and again at program discharge. Clinical data were extracted from medical charts. RESULTS: There were 779 participants: 45 Brazilian (5.8% of sample), 214 Canadian (27.5%), 126 Colombian (16.2%), 309 American (39.7%), and 85 Venezuelan (10.9%). Pre-CR depressive symptoms significantly differed between countries (P <.05), with Colombian participants reporting higher scores than Canadians and Venezuelans. Total PHQ-9 scores significantly decreased during CR in Colombia (mean change =-2.33; P <.001), the United States (mean change =-1.12; P <.001), and Venezuela (mean change =-2.14; P <.001), but not in Brazil (where less psychosocial intervention was offered) or Canada (where pre-CR scores were low). Among the 102 (13.1%) participants with scores in the elevated range pre-CR, the mean change in PHQ-9 scores was-6.57 ± 1.09 and 40 (39.2%) participants no longer had elevated symptoms postprogram. CONCLUSIONS: Depressive symptoms are variable among patients with CR in South and North American countries. CR programs incorporating psychosocial components can reduce these symptoms.
AB - PURPOSE: Depression is 3 times more prevalent in the cardiac than the general population in high-income countries and is particularly high in middle-income countries. Comorbid depression is associated with twice the mortality after a cardiovascular event. The objectives of this study were to describe and compare depressive symptoms pre-and postcardiac rehabilitation (CR) among patients in high-income countries and middle-income countries in the Americas. METHODS: The study design was prospective and observational. A convenience sample of CR participants completed the Patient Health Questionnaire-9 (PHQ-9) at CR intake and again at program discharge. Clinical data were extracted from medical charts. RESULTS: There were 779 participants: 45 Brazilian (5.8% of sample), 214 Canadian (27.5%), 126 Colombian (16.2%), 309 American (39.7%), and 85 Venezuelan (10.9%). Pre-CR depressive symptoms significantly differed between countries (P <.05), with Colombian participants reporting higher scores than Canadians and Venezuelans. Total PHQ-9 scores significantly decreased during CR in Colombia (mean change =-2.33; P <.001), the United States (mean change =-1.12; P <.001), and Venezuela (mean change =-2.14; P <.001), but not in Brazil (where less psychosocial intervention was offered) or Canada (where pre-CR scores were low). Among the 102 (13.1%) participants with scores in the elevated range pre-CR, the mean change in PHQ-9 scores was-6.57 ± 1.09 and 40 (39.2%) participants no longer had elevated symptoms postprogram. CONCLUSIONS: Depressive symptoms are variable among patients with CR in South and North American countries. CR programs incorporating psychosocial components can reduce these symptoms.
KW - Patient Health Questionnaire-9
KW - cardiac rehabilitation
KW - coronary artery disease
KW - depression
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UR - http://www.scopus.com/inward/citedby.url?scp=84967104253&partnerID=8YFLogxK
U2 - 10.1097/HCR.0000000000000189
DO - 10.1097/HCR.0000000000000189
M3 - Article
C2 - 27182759
AN - SCOPUS:84967104253
SN - 1932-7501
VL - 37
SP - 182
EP - 190
JO - Journal of Cardiopulmonary Rehabilitation and Prevention
JF - Journal of Cardiopulmonary Rehabilitation and Prevention
IS - 3
ER -