Abstract
Few studies assess the role of personality styles in predicting the onset of depression among cardiac patients. This study evaluates whether temperament and character can represent a risk factor for the development of incident first-ever depressive episodes in patients at their first acute coronary syndrome (ACS). Two hundred sixty-seven (72.1%) subjects (male) completed the Temperament and Character Inventory (TCI) a few days after the cardiac event. At baseline and after 1, 2, 4, 6, 9, 12, and 24 months of follow-up, the participants completed the Primary Care Evaluation of Mental Disorder (PRIME-MD) and the Hospital Anxiety and Depression Scale to establish the presence of a depressive episode and its severity. During the follow-up, 61 (22.8%) participants developed a depressive episode. Temperamental risk factors for incident depression were scored high on novelty seeking and harm avoidance at the TCI. Given the detrimental effect of depression on cardiac prognosis, clinicians should take temperament variables into account when determining the treatment plans of their patients with ACS.
Highlights
Few studies assess the role of personality styles in predicting the onset of depression among cardiac patients
Depression itself seems to have a negative impact on cardiac prognosis (Lichtman et al, 2014), but the role played by anxiety, severity of depressive symptoms, and recurrence of the episodes (Osler et al, 2016; Yammine et al, 2017; Zuidersma et al, 2011) is still object for debate
Depression after acute coronary syndrome (ACS) can be distinguished by incident depression, which occurs in patients who have never been depressed, and nonincident depression, which occurs when a depressive disorder is premorbid to the diagnosis of ACS
Summary
The study sample was selected among patients who were consecutively admitted to the Coronary Intensive Care Unit of the University Hospital of Parma, from January 2009 to March 2012, for an ACS. All subjects were presenting for the first time with ACS symptoms; an ST-segment elevation MI, a non–ST-segment elevation MI (NSTEMI), or unstable angina had been diagnosed (Hamm et al, 2011). Biomarkers (troponins) further distinguished NSTEMI and unstable angina (Hamm et al, 2011). Thirty-seven participants from the initial overall sample (n = 304) (see Ossola et al, 2015a) did not accurately complete the Temperament and Character Inventory (TCI) at baseline; the sample of the present study was composed of 267 subjects (49 women, 18.4%; average age, 60.82 ± 11.11 years; range, 32–86 years). No differences in sociodemographic variables emerged between the completers and the sample at baseline
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