Effects of resilient coping capacity on depression in patients following an acute coronary syndrome.

Abstract

Depression has been reported as significant predictors of morbidity and mortality in patients with acute coronary syndrome (ACS). This study tested the key components of a newly proposed model that developed from a well-established theory, Theory of Sense of Coherence (SOC) and accumulated evidences in research. The main interest of this study was to explore the resilient effect of SOC as a mediator on the depression as an indicator of psychosocial adjustment in the recovery phase of ACS. Post ACS patients (N = 100) were recruited prior to hospital discharge, at Time 1 and 82 patients remained in the study one month later at Time 2. Most participants in this prospective and longitudinal study were Caucasians and 59% were younger than 65 years old. Patients with higher SOC demonstrated much better health status and less depressive symptoms than those with lower SOC at each time. 31% of participants had a history of depression and 45% indicated mild to severe depressive symptoms at Time 1. Depressive symptoms remained prevalent during the one month post discharge and the Beck Depression Inventory (BDI-II) scores remained unchanged over the one month interval regardless of past history of depression, presence of depressive symptoms at Time 1, or taking antidepressants (AD). Although severity of depressive symptoms did not get worse over the one month period, insignificant declines of the BDI-II scores in study participants raise critical concerns about current clinical management for the post ACS patients who might be at risk of suffering from depression for the extended period. Furthermore, the BDI-II scores at Time 1 was the single powerful predictor for the BDI-II scores at Time 2. Perceived health status following ACS event was improved over the one-month period while SOC did not get better a month later. Perceived health status prior to hospital discharge did not show any predictive power for depressive symptoms at Time 2 compared to depressive symptoms immediately after ACS event. Gender was associated to history of depression and taking AD. Age difference was significant in groups with and without a history of depression and in groups taking and not taking AD.