Severity of Depressive Symptoms Pre-and Postcardiac Rehabilitation: A COMPARISON among PATIENTS in Brazil, CANADA, COLOMBIA, the UNITED STATES, and VENEZUELA

Gabriela Lima De Melo Ghisi, Claudia Victoria Anchique Santos, Briseida Benaim, Francisco Lopez-Jimenez, Artur Haddad Herdy, Jose Medina Inojosa, Carmen M. Terzic, Lisiane Janovik, Maria Fernanda Rojas, Sherry L. Grace

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

PURPOSE: Depression is 3 times more prevalent in the cardiac than the general population in high-income countries and is particularly high in middle-income countries. Comorbid depression is associated with twice the mortality after a cardiovascular event. The objectives of this study were to describe and compare depressive symptoms pre-and postcardiac rehabilitation (CR) among patients in high-income countries and middle-income countries in the Americas. METHODS: The study design was prospective and observational. A convenience sample of CR participants completed the Patient Health Questionnaire-9 (PHQ-9) at CR intake and again at program discharge. Clinical data were extracted from medical charts. RESULTS: There were 779 participants: 45 Brazilian (5.8% of sample), 214 Canadian (27.5%), 126 Colombian (16.2%), 309 American (39.7%), and 85 Venezuelan (10.9%). Pre-CR depressive symptoms significantly differed between countries (P <.05), with Colombian participants reporting higher scores than Canadians and Venezuelans. Total PHQ-9 scores significantly decreased during CR in Colombia (mean change =-2.33; P <.001), the United States (mean change =-1.12; P <.001), and Venezuela (mean change =-2.14; P <.001), but not in Brazil (where less psychosocial intervention was offered) or Canada (where pre-CR scores were low). Among the 102 (13.1%) participants with scores in the elevated range pre-CR, the mean change in PHQ-9 scores was-6.57 ± 1.09 and 40 (39.2%) participants no longer had elevated symptoms postprogram. CONCLUSIONS: Depressive symptoms are variable among patients with CR in South and North American countries. CR programs incorporating psychosocial components can reduce these symptoms.

Original languageEnglish (US)
Pages (from-to)182-190
Number of pages9
JournalJournal of Cardiopulmonary Rehabilitation and Prevention
Volume37
Issue number3
DOIs
StatePublished - May 1 2017

Keywords

  • Patient Health Questionnaire-9
  • cardiac rehabilitation
  • coronary artery disease
  • depression

ASJC Scopus subject areas

  • Rehabilitation
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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