Contribution of depression and anxiety to impaired health-related quality of life following first myocardial infarction

Abstract

Background: The extent to which depression impairs health-related quality of life (HRQoL) in the physically ill has not been clearly established. Aims: To quantify the adverse influence of depression and anxiety, assessed at the time of first myocardial infarction and 6 months later, on the physical aspect of HRQoL 12 months after the infarction. Method: In all, 260 in-patients, admitted following first myocardial infarction, completed the Hospital Anxiety and Depression Scale and the Medical Outcomes Study SF-36 assessment before discharge and at 6- and 12-month follow-up. Results: Depression and anxiety 6 months after myocardial infarction predicted subsequent impairment in the physical aspects of HRQoL (attributable adjusted R2=9%, P<0.0005). These negative effects of depression and anxiety on outcome were mediated by feelings of fatigue. Depression and anxiety present before myocardial infarction did not predict HRQoL 12 months after myocardial infarction. Conclusions: Detection and treatment of depression and anxiety following myocardial infarction improve the patient's health-related quality of life. Declaration of interest: F.H.C. has performed consultancy work for Ely Lilly in a field unconnected with the current study. There are no other conflicts of interest to declare.