Changing depressive symptoms following percutaneous coronary intervention, clustering and effect on adherence

The THORESCI study

M.P.A.J. Versteeg, E.M.J. van Montfort, J. Denollet, N. Kupper

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Background: 

Depressive symptom dimensions may have a differential effect on cardiac prognosis. It is yet unknown whether and how depressive symptoms change together over time and how this may affect disease progression. We examined the clustering of changing depressive symptoms over the first 6 months after percutaneous coronary intervention (PCI), and examined the influence of the change profile on the predictive value of depression for treatment adherence at 6 months post-PCI.

Methods: 

PCI patients (N=219, age: 62±15, 20% women) reported on depressive symptoms (PHQ-9, BDI; 30 symptoms) and adherence (MOS-GAS) at 1 and 6 months post-PCI. Principal component analysis (PCA) was performed on the individual symptom change scores. Multivariable linear regression examined the role of change profiles in predicting general treatment adherence, while adjusting for demographic and clinical characteristics.

Results: 

Four change-factors emerged from PCA. One somatic-affective change-factor (10 symptoms), two cognitive-affective change-factors (6 general cognitive-affective and 7 severe cognitive symptoms) and one mixed factor were identified. We extracted 5 symptom change profiles. Linear regression showed the moderating role of the change profiles. In patients reporting a net increase in depressive symptoms, higher cognitive affective symptoms (β=-.46, p=.001) and higher somatic-affective symptoms (β=-.29; p=.044) were associated with worse general adherence.

Discussion: 

Four distinct depressive symptom change-factors were identified that moderated the association of somatic-affective and cognitive-affective depressive symptom levels with general treatment adherence. This is of clinical importance as not only current symptoms, but also symptom change over the preceding months may be important to consider in screening and risk prediction.

Original languageEnglish
Pages (from-to)146-153
JournalJournal of Affective Disorders
Volume204
DOIs
Publication statusPublished - 2016

Fingerprint

Cluster Analysis
Depression
Affective Symptoms
Linear Models

Keywords

  • Percutaneous coronary intervention
  • Coronary Artery Disease
  • Depression
  • change
  • Adherence
  • Health Behaviors

Cite this

@article{4c85911cfe824fd2b19339a5cc6313c3,
title = "Changing depressive symptoms following percutaneous coronary intervention, clustering and effect on adherence: The THORESCI study",
abstract = "Background: Depressive symptom dimensions may have a differential effect on cardiac prognosis. It is yet unknown whether and how depressive symptoms change together over time and how this may affect disease progression. We examined the clustering of changing depressive symptoms over the first 6 months after percutaneous coronary intervention (PCI), and examined the influence of the change profile on the predictive value of depression for treatment adherence at 6 months post-PCI.Methods: PCI patients (N=219, age: 62±15, 20{\%} women) reported on depressive symptoms (PHQ-9, BDI; 30 symptoms) and adherence (MOS-GAS) at 1 and 6 months post-PCI. Principal component analysis (PCA) was performed on the individual symptom change scores. Multivariable linear regression examined the role of change profiles in predicting general treatment adherence, while adjusting for demographic and clinical characteristics.Results: Four change-factors emerged from PCA. One somatic-affective change-factor (10 symptoms), two cognitive-affective change-factors (6 general cognitive-affective and 7 severe cognitive symptoms) and one mixed factor were identified. We extracted 5 symptom change profiles. Linear regression showed the moderating role of the change profiles. In patients reporting a net increase in depressive symptoms, higher cognitive affective symptoms (β=-.46, p=.001) and higher somatic-affective symptoms (β=-.29; p=.044) were associated with worse general adherence.Discussion: Four distinct depressive symptom change-factors were identified that moderated the association of somatic-affective and cognitive-affective depressive symptom levels with general treatment adherence. This is of clinical importance as not only current symptoms, but also symptom change over the preceding months may be important to consider in screening and risk prediction.",
keywords = "Percutaneous coronary intervention, Coronary Artery Disease, Depression, change, Adherence, Health Behaviors",
author = "M.P.A.J. Versteeg and {van Montfort}, E.M.J. and J. Denollet and N. Kupper",
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doi = "10.1016/j.jad.2016.06.050",
language = "English",
volume = "204",
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journal = "Journal of Affective Disorders",
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}

Changing depressive symptoms following percutaneous coronary intervention, clustering and effect on adherence : The THORESCI study. / Versteeg, M.P.A.J.; van Montfort, E.M.J.; Denollet, J.; Kupper, N.

In: Journal of Affective Disorders, Vol. 204, 2016, p. 146-153.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Changing depressive symptoms following percutaneous coronary intervention, clustering and effect on adherence

T2 - The THORESCI study

AU - Versteeg, M.P.A.J.

AU - van Montfort, E.M.J.

AU - Denollet, J.

AU - Kupper, N.

N1 - Copyright © 2016 Elsevier B.V. All rights reserved.

PY - 2016

Y1 - 2016

N2 - Background: Depressive symptom dimensions may have a differential effect on cardiac prognosis. It is yet unknown whether and how depressive symptoms change together over time and how this may affect disease progression. We examined the clustering of changing depressive symptoms over the first 6 months after percutaneous coronary intervention (PCI), and examined the influence of the change profile on the predictive value of depression for treatment adherence at 6 months post-PCI.Methods: PCI patients (N=219, age: 62±15, 20% women) reported on depressive symptoms (PHQ-9, BDI; 30 symptoms) and adherence (MOS-GAS) at 1 and 6 months post-PCI. Principal component analysis (PCA) was performed on the individual symptom change scores. Multivariable linear regression examined the role of change profiles in predicting general treatment adherence, while adjusting for demographic and clinical characteristics.Results: Four change-factors emerged from PCA. One somatic-affective change-factor (10 symptoms), two cognitive-affective change-factors (6 general cognitive-affective and 7 severe cognitive symptoms) and one mixed factor were identified. We extracted 5 symptom change profiles. Linear regression showed the moderating role of the change profiles. In patients reporting a net increase in depressive symptoms, higher cognitive affective symptoms (β=-.46, p=.001) and higher somatic-affective symptoms (β=-.29; p=.044) were associated with worse general adherence.Discussion: Four distinct depressive symptom change-factors were identified that moderated the association of somatic-affective and cognitive-affective depressive symptom levels with general treatment adherence. This is of clinical importance as not only current symptoms, but also symptom change over the preceding months may be important to consider in screening and risk prediction.

AB - Background: Depressive symptom dimensions may have a differential effect on cardiac prognosis. It is yet unknown whether and how depressive symptoms change together over time and how this may affect disease progression. We examined the clustering of changing depressive symptoms over the first 6 months after percutaneous coronary intervention (PCI), and examined the influence of the change profile on the predictive value of depression for treatment adherence at 6 months post-PCI.Methods: PCI patients (N=219, age: 62±15, 20% women) reported on depressive symptoms (PHQ-9, BDI; 30 symptoms) and adherence (MOS-GAS) at 1 and 6 months post-PCI. Principal component analysis (PCA) was performed on the individual symptom change scores. Multivariable linear regression examined the role of change profiles in predicting general treatment adherence, while adjusting for demographic and clinical characteristics.Results: Four change-factors emerged from PCA. One somatic-affective change-factor (10 symptoms), two cognitive-affective change-factors (6 general cognitive-affective and 7 severe cognitive symptoms) and one mixed factor were identified. We extracted 5 symptom change profiles. Linear regression showed the moderating role of the change profiles. In patients reporting a net increase in depressive symptoms, higher cognitive affective symptoms (β=-.46, p=.001) and higher somatic-affective symptoms (β=-.29; p=.044) were associated with worse general adherence.Discussion: Four distinct depressive symptom change-factors were identified that moderated the association of somatic-affective and cognitive-affective depressive symptom levels with general treatment adherence. This is of clinical importance as not only current symptoms, but also symptom change over the preceding months may be important to consider in screening and risk prediction.

KW - Percutaneous coronary intervention

KW - Coronary Artery Disease

KW - Depression

KW - change

KW - Adherence

KW - Health Behaviors

U2 - 10.1016/j.jad.2016.06.050

DO - 10.1016/j.jad.2016.06.050

M3 - Article

VL - 204

SP - 146

EP - 153

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

SN - 0165-0327

ER -