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Cognitive/affective and somatic/affective symptoms of depression in patients with heart disease and their association with cardiovascular prognosis: a meta-analysis

de Miranda Azevedo, R. ; Roest, A. M. ; Hoen, P. W. ; de Jonge, P.

Psychological medicine, 2014-10, Vol.44 (13), p.2689-2703 [Periódico revisado por pares]

Cambridge, UK: Cambridge University Press

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  • Título:
    Cognitive/affective and somatic/affective symptoms of depression in patients with heart disease and their association with cardiovascular prognosis: a meta-analysis
  • Autor: de Miranda Azevedo, R. ; Roest, A. M. ; Hoen, P. W. ; de Jonge, P.
  • Assuntos: Adult and adolescent clinical studies ; Biological and medical sciences ; Cardiovascular disease ; Cardiovascular Diseases - diagnosis ; Cardiovascular Diseases - epidemiology ; Comorbidity ; Depression ; Depression - epidemiology ; Heart Diseases - epidemiology ; Humans ; Medical prognosis ; Medical sciences ; Mental depression ; Meta-analysis ; Miscellaneous ; Mood disorders ; Prognosis ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Systematic review
  • É parte de: Psychological medicine, 2014-10, Vol.44 (13), p.2689-2703
  • Notas: ObjectType-Article-2
    SourceType-Scholarly Journals-1
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    ObjectType-Review-3
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  • Descrição: Several prospective longitudinal studies have suggested that somatic/affective depressive symptoms, but not cognitive/affective depressive symptoms, are related to prognosis in patients with heart disease, but findings have been inconsistent. The aim of this study was to investigate the association of cognitive/affective and somatic/affective symptoms of depression with cardiovascular prognosis in patients with heart disease using a meta-analytic perspective. A systematic search was performed in PubMed, EMBASE and PsycInfo. Thirteen prospective studies on symptom dimensions of depression and cardiovascular prognosis fulfilled the inclusion criteria, providing data on a total of 11,128 subjects. The risk estimates for each dimension of depressive symptoms, demographic and methodological variables were extracted from the included articles. In least-adjusted analyses, both the somatic/affective [hazard ratio (HR) 1.30, 95% confidence interval (CI) 1.19-1.41, p < 0.001] and cognitive/affective (HR 1.07, 95% CI 1.00-1.15, p = 0.05) dimensions of depressive symptoms were associated with cardiovascular prognosis. In fully adjusted analyses, somatic/affective symptoms were significantly associated with adverse prognosis (HR 1.19, 95% CI 1.10-1.29, p < 0.001) but cognitive/affective symptoms were not (HR 1.04, 95% CI 0.97-1.12, p = 0.25). An increase of one standard deviation (±1 s.d.) in the scores of the somatic/affective dimension was associated with a 32% increased risk of adverse outcomes (HR 1.32, 95% CI 1.17-1.48, p < 0.001). Somatic/affective depressive symptoms were more strongly and consistently associated with mortality and cardiovascular events in patients with heart disease compared with cognitive/affective symptoms. Future research should focus on the mechanisms by which somatic/affective depressive symptoms may affect cardiovascular prognosis.
  • Editor: Cambridge, UK: Cambridge University Press
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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