Severity of Depressive Symptoms Pre- and Postcardiac Rehabilitation: A COMPARISON AMONG PATIENTS IN BRAZIL, CANADA, COLOMBIA, THE UNITED STATES, AND VENEZUELA. Issue 3 (May 2017)

• Record Type: Journal Article
• Authors: Ghisi, Gabriela Lima de Melo; Santos, Claudia Victoria Anchique; Benaim, Briseida; Lopez-Jimenez, Francisco; Herdy, Artur Haddad; Inojosa, Jose Medina; Terzic, Carmen M.; Janovik, Lisiane; Rojas, Maria Fernanda; Grace, Sherry L.
• Is Part Of: Journal of cardiopulmonary rehabilitation and prevention. Volume 37:Issue 3(2017)
• Publication Date: 2017-05
• Subjects: cardiac rehabilitation -- coronary artery disease -- depression -- Patient Health Questionnaire-9; Cardiopulmonary system -- Diseases -- Patients -- Rehabilitation -- Periodicals; Cardiopulmonary system -- Diseases -- Prevention -- Periodicals; 616.103
• DOI: 10.1097/HCR.0000000000000189
• Languages: English
• ISSNs: 1932-7501

Abstract

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. Abstract : Depressive symptoms pre- and postcardiac rehabilitation among patients in 5 countries (Brazil, Canada, Colombia, the United States, and Venezuela) were described and compared. Symptom severity varied by country. Those with elevated symptoms realized clinically significant reductions, demonstrating that participating in cardiac rehabilitation programs with psychosocial components can reduce these symptoms.