Abstract
BackgroundTreatment of depression in cardiac patients is difficult. Patients’ illness beliefs regarding depression are associated with outcomes. The aim of the mixed-methods study was to test whether patients in routine care for depression differ from patients with depression in routine care for cardiac diseases regarding illness beliefs about depression.MethodsA consecutive sample of n = 217 patients with depressive disorder was recruited from routine care for depression (N = 148) and routine care for cardiac diseases (N = 69). Beliefs about depression were measured by the Brief-Illness Perception Questionnaire. Causal beliefs were categorized using qualitative methods. To investigate differences regarding other illness beliefs, we performed an ANCOVA controlling for sociodemographic and clinical differences by propensity score matching.ResultsPatients in routine care for cardiac diseases attributed their depression more often to physical illnesses (48% vs. 16%) and less often to their self (30% vs. 47%), problems at work (25% vs. 35%), childhood (25% vs. 30%), and negative life events (19% vs. 25%) in contrast to patients in routine care for depression. Patients in routine care for cardiac diseases reported beliefs of lower disability, burden, and treatment-control and of higher self-control in contrast to patients in routine care for depression.ConclusionsIllness beliefs especially causal beliefs differ between patients in routine care for cardiac diseases and routine care for depression. Future research should investigate effects of these illness beliefs. We recommend exploring patients’ illness beliefs about depression in routine care for cardiac diseases and routine care for depression.
Highlights
Treatment of depression in cardiac patients is difficult
There was no difference between participants from routine care for cardiac disease (RCC) and routine care for depression (RCD) with regard to depression severity
Depression severity was positively associated with consequences (r = .385, p < .001), timeline (r = .337, p < .001), and identity (r = .406, p < .001), negatively associated with personal control (r = −.213, p = .002) and treatment control (r = −.156, p = .022) and not associated with comprehensibility (r = −.058, p = .399), irrespective of controlling for RCD and RCC or not
Summary
Treatment of depression in cardiac patients is difficult. Patients’ illness beliefs regarding depression are associated with outcomes. The aim of the mixed-methods study was to test whether patients in routine care for depression differ from patients with depression in routine care for cardiac diseases regarding illness beliefs about depression. Effective psychotherapeutic and psychopharmacological treatment options are available. In contrast to patients with depression without somatic comorbidity, psychotherapeutic and psychopharmacological treatments have only modest effects on depression severity among patients with depression and cardiac diseases [3,4,5,6]. Besides potential biological influences of cardiac risk markers (e.g. thyroid hormones and inflammatory blood markers) on response to depression treatment [7], patients’
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