Abstract
BackgroundPatients with cardiac disease with or without depression may also have major physical and mental problems. This study assesses and compares the quality of life (QOL) of patients with cardiac disease with and without depression and accompanying comorbidities.MethodsA cross-sectional study was conducted with a convenience sample of 388 patients with cardiac disease. The 12-item Short-Form (SF-12)-patient was used to measure physical component scale (PCS) and mental component scale (MCS) QOL, and the Patient Health Questionnaire (PHQ-9) was used to measure depression. The Charlson Comorbidity Index was used to estimate 10-year survival probability. Descriptive statistics, analysis of covariance (ANCOVA), chi-square tests, and binary logistic regression were used for analysis.ResultsThe prevalence of minimal to mild depression was 65.7% [(95% CI (60.8, 70.4)] and that of moderate to severe depression was 34.3% [95% CI (29.6, 39.2)]. There was no significant association between the level of PHQ-categorised depression and age (p = 0.171), sex (p = 0.079), or ethnicity (p = 0.407). The overall mean PCS and MCS QOL was 32.5 [95% CI (24.4, 40.64)] and 45.4 [95% CI (44.4, 46.4)], respectively, with no significant correlation between PCS and MCS [r (Pearson’s) = 0.011; p = 0.830)]. There were QOL differences among the five PHQ categories (PCS: p = 0.028; MCS: p ≤ 0.001) with both MCS and PCS decreasing with increasing depression. ANCOVA (with number of comorbidities as the covariate) showed a significant age × ethnicity interaction for PCS (p = 0.044) and MCS (p = 0.039), respectively. Young Indo-Trinidadians had significantly lower PCS than did Afro-Trinidadians, while the converse was true for MCS. Depression, age, and number of comorbidities were predictors of PCS, while depression, age, and sex were predictors of MCS.ConclusionsIncreasing severity of depression worsened both PCS and MCS QOL. Age and level of clinical depression predicted QOL, with number of comorbidities predicting only PCS and sex predicting only MCS. Efforts must be made to treat depression in all age groups of patients with cardiac disease.
Highlights
Patients with cardiac disease with or without depression may have major physical and mental problems
Many studies in developing countries have reported on poor quality of life (QOL) experienced by patients with cardiac disease with depression [16] who are two times more likely to die after a cardiac event [17]
Because of the protocols used for patient admission in these three hospitals, there is no reason to expect that the patients treated for Cardiovascular disease (CVD) at this institution significantly differed from those treated in the non-participating hospitals during the study period in any characteristic that would affect the findings of the study due to non-participation
Summary
Patients with cardiac disease with or without depression may have major physical and mental problems. This study assesses and compares the quality of life (QOL) of patients with cardiac disease with and without depression and accompanying comorbidities. Quality of life (QOL) is a major outcome indicator of patients with cardiac disease with or without comorbidities such as depression, other psychosocial factors, and a multitude of chronic non-communicable diseases. A strong association has been observed between symptoms of depression and health status, symptom burden, physical limitation, QOL, and overall health among patients with coronary artery disease (CAD) [10]. Studies on QOL among patients with cardiac disease with depression have not been reported in Trinidad and Tobago. This study sought to examine and compare QOL among, and between, patients with cardiac disease with or without depression admitted to public tertiary health institutions in Trinidad and Tobago
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