Article

While there is evidence of poor health behaviours in anxious and
depressed cardiac patients, it is possible that sociodemographic factors explain
these associations. Few previous studies have adequately controlled for
confounders. The present study investigated health behaviours in anxious and
depressed cardiac patients, while accounting for sociodemographic confounders.
METHOD: A consecutive sample of 275 patients admitted to hospital after acute
myocardial infarction (32%) or for coronary bypass surgery (40%) or percutaneous
coronary intervention (28%) was interviewed six weeks after hospital discharge.
Anxiety and depression were assessed using the Hospital Anxiety and Depression
Scale (HADS). Smoking, physical activity, alcohol intake and dietary fat intake
were assessed by self-report. Backward stepwise logistic regression was used to
identify the factors independently associated with anxiety and depression.
RESULTS: In total, 41 patients (15.2%) were 'depressed' (HADS-D >/=8) while 68
(25.2%) were 'anxious' (HADS-A >/=8). Depressed patients reported higher rates of
smoking (chi2)= 4.47, p = 0.034), lower physical activity (F = 8.63, p < 0.004)
and higher dietary fat intake (F = 7.22, p = 0.008) than non-depressed patients.
Anxious patients reported higher smoking rates (chi2)= 5.70, p = 0.024) and
dietary fat intake (F = 7.71, p = 0.006) than non-anxious patients. In
multivariate analyses, an association with depression was retained for both diet
and physical activity, and an association with anxiety was retained for diet. Low
social support and younger age were significant confounders with depression and
anxiety respectively. CONCLUSIONS: While the high smoking rates evidenced in
anxious and depressed patients were explained by sociodemographic factors, their
poor diet and low physical activity (depressed patients only) were independent of
these factors. Given the impact of lifestyle modification on survival after a
cardiac event, anxious and depressed patients should be a priority for cardiac
rehabilitation and other secondary prevention programmes.

Langue : ANGLAIS