Are illness perceptions about coronary artery disease predictive of depression and quality of life outcomes?

• Published in: Journal of psychosomatic research 2009-03, Vol.66 (3), p.211-220
• Main Authors: Stafford, Lesley, Berk, Michael, Jackson, Henry J
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Aged; Aged, 80 and over; Angioplasty, Balloon, Coronary - psychology; Biological and medical sciences; Cardiology. Vascular system; Comorbidity; Coronary Artery Bypass - psychology; Coronary artery disease; Coronary Disease - psychology; Coronary Disease - surgery; Coronary diseases; Coronary heart disease; Culture; Depression; Depression - psychology; Diabetes Mellitus, Type 2 - psychology; Female; Health beliefs; Health status; Heart; Hospitalization; Humans; Illness Behavior; Illness perceptions; Internal-External Control; Male; Medical sciences; Middle Aged; Mood disorders; Myocardial Infarction - psychology; Myocardial Infarction - surgery; Perceptions; Personality Inventory - statistics & numerical data; Prospective Studies; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychometrics; Psychopathology. Psychiatry; Quality of life; Quality of Life - psychology; Smoking - psychology; Social Support
• ISSN: 0022-3999; 1879-1360
• DOI: 10.1016/j.jpsychores.2008.09.005

Abstract Objective Depression occurs commonly in coronary artery disease (CAD) and is associated with substantial disability. Modifiable cognitive determinants of depression in this population have not been identified. We investigated the impact of potentially modifiable illness beliefs about CAD on depressive symptomatology. We also examined the association between these beliefs and health-related quality of life (HRQOL) and socio-demographic variations in illness beliefs. Methods A prospective study of 193 recently hospitalized CAD patients was conducted. Data were collected from medical records and by self-report 3 and 9 months post-discharge. Socio-demographic differences were analysed with independent sample t -tests. Predictive models were tested in a series of hierarchical linear regression equations that controlled for known clinical, psychosocial, and demographic correlates of outcome. Results Negative illness beliefs, particularly those associated with the consequences of CAD, were significantly predictive of higher levels of depressive symptomatology at 3 and 9 months. Positive illness perceptions were significantly associated with better HRQOL outcomes. Older and less socially advantaged patients demonstrated more negative illness beliefs. Conclusions Illness beliefs are significantly associated with depressive symptomatology and HRQOL in CAD patients. These beliefs can be easily identified and constitute a meaningful and clinically accessible avenue for improving psychological morbidity and HRQOL in CAD patients. Older and more socially vulnerable patients may require heightened monitoring of their illness beliefs. Research needs to translate these and other predictive findings into interventions.