Somatic versus cognitive depressive symptoms as predictors of coronary artery disease among women with suspected ischemia: The women's ischemia syndrome evaluation
Background: Depression is an established predictor of coronary artery disease (CAD) progression and mortality. “Somatic” symptoms of depression such as fatigue and sleep impairment overlap with symptoms of CAD and independently predict CAD events. Differentiating between “somatic” and “cognitive” de...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2021-01-01
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| Series: | Heart and Mind |
| Subjects: | |
| Online Access: | http://www.heartmindjournal.org/article.asp?issn=2468-6476;year=2021;volume=5;issue=4;spage=112;epage=118;aulast=Emami |
| _version_ | 1818694319961276416 |
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| author | Ashley S Emami C Noel Bairey Merz Jo-Ann Eastwood Carl J Pepine Eileen M Handberg Vera Bittner Puja K Mehta David S Krantz Viola Vaccarino Wafia Eteiba Carol E Cornell Thomas Rutledge |
| author_facet | Ashley S Emami C Noel Bairey Merz Jo-Ann Eastwood Carl J Pepine Eileen M Handberg Vera Bittner Puja K Mehta David S Krantz Viola Vaccarino Wafia Eteiba Carol E Cornell Thomas Rutledge |
| author_sort | Ashley S Emami |
| collection | DOAJ |
| description | Background: Depression is an established predictor of coronary artery disease (CAD) progression and mortality. “Somatic” symptoms of depression such as fatigue and sleep impairment overlap with symptoms of CAD and independently predict CAD events. Differentiating between “somatic” and “cognitive” depressive symptoms in at-risk patients may improve our understanding of the relationship between depression and CAD. Methods: The study utilized data from the Women's Ischemia Syndrome Evaluation. Participants (N = 641; mean age = 58.0 [11.4] years) were enrolled to evaluate chest pain or suspected myocardial ischemia. They completed a battery of symptom and psychological questionnaires (including the Beck Depression Inventory [BDI]) at baseline, along with quantitative coronary angiography and other CAD diagnostic procedures. The BDI provided scores for total depression and for cognitive and somatic depressive symptom subscales. Results: Two hundred and fourteen (33.4%) women met criteria for obstructive CAD. Logistic regression models were used to examine relationships between depression symptoms and obstructive CAD. Neither BDI total scores (odds ratio [OR] =1.02, 95% confidence interval [CI], 0.99–1.05, P = 0.053) nor BDI cognitive scores (OR = 1.02, 95% CI, 1.00–1.04, P = 0.15) predicted CAD status. BDI somatic symptom scores, however, significantly predicted CAD status and remained statistically significant after controlling for age, race, and education (OR = 1.06, 95% CI, 1.01–1.12, P = 0.02). Conclusion: Among women with suspected myocardial ischemia, somatic but not cognitive depressive symptoms predicted an increased risk of obstructive CAD determined by coronary angiography. Consistent with prior reports, these results suggest a focus on somatic rather than cognitive depressive symptoms could offer additional diagnostic information. |
| first_indexed | 2024-12-17T13:27:42Z |
| format | Article |
| id | doaj.art-38249bfb5f104034b956f4a4234acaf3 |
| institution | Directory Open Access Journal |
| issn | 2468-6476 2468-6484 |
| language | English |
| last_indexed | 2024-12-17T13:27:42Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Heart and Mind |
| spelling | doaj.art-38249bfb5f104034b956f4a4234acaf32022-12-21T21:46:40ZengWolters Kluwer Medknow PublicationsHeart and Mind2468-64762468-64842021-01-015411211810.4103/hm.hm_34_21Somatic versus cognitive depressive symptoms as predictors of coronary artery disease among women with suspected ischemia: The women's ischemia syndrome evaluationAshley S EmamiC Noel Bairey MerzJo-Ann EastwoodCarl J PepineEileen M HandbergVera BittnerPuja K MehtaDavid S KrantzViola VaccarinoWafia EteibaCarol E CornellThomas RutledgeBackground: Depression is an established predictor of coronary artery disease (CAD) progression and mortality. “Somatic” symptoms of depression such as fatigue and sleep impairment overlap with symptoms of CAD and independently predict CAD events. Differentiating between “somatic” and “cognitive” depressive symptoms in at-risk patients may improve our understanding of the relationship between depression and CAD. Methods: The study utilized data from the Women's Ischemia Syndrome Evaluation. Participants (N = 641; mean age = 58.0 [11.4] years) were enrolled to evaluate chest pain or suspected myocardial ischemia. They completed a battery of symptom and psychological questionnaires (including the Beck Depression Inventory [BDI]) at baseline, along with quantitative coronary angiography and other CAD diagnostic procedures. The BDI provided scores for total depression and for cognitive and somatic depressive symptom subscales. Results: Two hundred and fourteen (33.4%) women met criteria for obstructive CAD. Logistic regression models were used to examine relationships between depression symptoms and obstructive CAD. Neither BDI total scores (odds ratio [OR] =1.02, 95% confidence interval [CI], 0.99–1.05, P = 0.053) nor BDI cognitive scores (OR = 1.02, 95% CI, 1.00–1.04, P = 0.15) predicted CAD status. BDI somatic symptom scores, however, significantly predicted CAD status and remained statistically significant after controlling for age, race, and education (OR = 1.06, 95% CI, 1.01–1.12, P = 0.02). Conclusion: Among women with suspected myocardial ischemia, somatic but not cognitive depressive symptoms predicted an increased risk of obstructive CAD determined by coronary angiography. Consistent with prior reports, these results suggest a focus on somatic rather than cognitive depressive symptoms could offer additional diagnostic information.http://www.heartmindjournal.org/article.asp?issn=2468-6476;year=2021;volume=5;issue=4;spage=112;epage=118;aulast=Emamibeck depression inventorycoronary artery diseasedepressionischemiawomen |
| spellingShingle | Ashley S Emami C Noel Bairey Merz Jo-Ann Eastwood Carl J Pepine Eileen M Handberg Vera Bittner Puja K Mehta David S Krantz Viola Vaccarino Wafia Eteiba Carol E Cornell Thomas Rutledge Somatic versus cognitive depressive symptoms as predictors of coronary artery disease among women with suspected ischemia: The women's ischemia syndrome evaluation Heart and Mind beck depression inventory coronary artery disease depression ischemia women |
| title | Somatic versus cognitive depressive symptoms as predictors of coronary artery disease among women with suspected ischemia: The women's ischemia syndrome evaluation |
| title_full | Somatic versus cognitive depressive symptoms as predictors of coronary artery disease among women with suspected ischemia: The women's ischemia syndrome evaluation |
| title_fullStr | Somatic versus cognitive depressive symptoms as predictors of coronary artery disease among women with suspected ischemia: The women's ischemia syndrome evaluation |
| title_full_unstemmed | Somatic versus cognitive depressive symptoms as predictors of coronary artery disease among women with suspected ischemia: The women's ischemia syndrome evaluation |
| title_short | Somatic versus cognitive depressive symptoms as predictors of coronary artery disease among women with suspected ischemia: The women's ischemia syndrome evaluation |
| title_sort | somatic versus cognitive depressive symptoms as predictors of coronary artery disease among women with suspected ischemia the women s ischemia syndrome evaluation |
| topic | beck depression inventory coronary artery disease depression ischemia women |
| url | http://www.heartmindjournal.org/article.asp?issn=2468-6476;year=2021;volume=5;issue=4;spage=112;epage=118;aulast=Emami |
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