Emotional coping is a better predictor of cardiac prognosis than depression and anxiety

• Published in: Journal of psychosomatic research 2012-12, Vol.73 (6), p.473-475
• Main Authors: Chiavarino, Claudia, Rabellino, Daniela, Ardito, Rita B, Cavallero, Erika, Palumbo, Luigi, Bergerone, Serena, Gaita, Fiorenzo, Bara, Bruno G
• Format: Article
• Language: English
• Subjects: Acute coronary syndrome; Acute Coronary Syndrome - diagnosis; Acute Coronary Syndrome - psychology; Adaptation, Psychological - physiology; Anxiety - complications; Anxiety - physiopathology; Cardiac rehabilitation; Constructivism; Depression; Depression - complications; Depression - physiopathology; Emotion-focused coping; Female; Humans; Male; Middle Aged; Prognosis; Prospective Studies; Psychiatric Status Rating Scales; Psychiatry; Severity of Illness Index; Stroke Volume
• ISSN: 0022-3999; 1879-1360
• DOI: 10.1016/j.jpsychores.2012.10.002

Abstract Objective We compared, in a prospective study on patients with acute coronary syndrome, the predictive effect of a depression or anxiety diagnosis and of emotion-focused, problem-focused and dysfunctional coping strategies, as detected early after an acute event, on patients’ left ventricular ejection fraction (LVEF), a reliable prognostic index of disease severity, at a three-month follow up. Methods Ninety consecutive patients following an acute coronary syndrome event (83.3% men; mean age 56.9±8.9 years) were included in the study. Demographic and clinical characteristics, presence of depression and anxiety disorders (MINI), and active use of emotion-focused, problem-focused and dysfunctional coping strategies (Brief Cope) were assessed at the time of enrolment. LVEF at a three-month follow up was used as the outcome measure. Results The medical predictors of LVEF accounted for 10.6% of the variance of LVEF at follow up. Emotion-focused coping strategies significantly contributed for an additional 6.1%, while the presence of a depression and/or anxiety disorder was not a significant predictor of LVEF at follow up, nor were dysfunctional and problem-focused coping strategies. Conclusion Emotion-focused coping strategies at the time of the cardiac event were the only reliable psychological predictor of disease severity at a three-month follow up. These findings hint to the possibility that variables such as emotional coping may be a fruitful target for psychological treatments directed at cardiac patients in primary care settings.