The relationship of social support, social networks and negative events with depression in patients with coronary artery disease

Abstract

This study examined the relationship of social relationships and negative life events with major depression among 335 inpatients with coronary artery disease (CAD) who were free of neurological illnesses. Depression was assessed using the Duke Depression Evaluation Schedule, a structured psychiatric interview which included the Diagnostic Interview Schedule depression sub-scale, two scales for measuring instrumental and self-maintenance activities of daily living, a measure of negative events and four dimensions of social support. Twenty-seven subjects met DSM-IV criteria for major depression. Examination of the bivariate relationships indicated that being younger, having at least one problem with an ADL and/or one IADL, being non-white, experiencing a greater number of negative events, lack of perceived social support and a lack of social interactions were significantly related to an increased likelihood of being depressed. In multivariate analyses depressed subjects were significantly more likely to report a greater number of negative events than non-depressed individuals after adjusting for sociodemographic and ADL measures. A lack of perceived social support and increased number of negative events increased the likelihood of reporting major depressive symptoms among CAD patients. Understanding the causes of depression in CAD patients may have clinical utility in that reduction in depression may lead to a decreased risk of future CAD events.