RT Journal
A1 Kendel F, Gelbrich G, Wirtz M, et al
T1 PRedictive relationship between depression and physical functioning after coronary surgery
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 2010
FD October 25
VO 170
IS 19
SP 1717
OP 1721
DO 10.1001/archinternmed.2010.368
UL http://dx.doi.org/10.1001/archinternmed.2010.368
AB Background 
    Depression is a prevalent condition in patients undergoing coronary artery bypass graft surgery (CABG) and is often associated with a less favorable health status. The aim of this study was to investigate the relationship between depression and physical functioning in patients undergoing CABG.Methods 
    The analyses were based on a sample of 883 consecutive subjects (aged 35-93 years; 19.8% women) undergoing CABG. Depression was assessed using the Patient Health Questionnaire (PHQ); the subscale “physical functioning” was taken from the 36-Item Short-Form Health Survey. Questionnaires were administered 1 to 3 days before surgery (T1) and 2 months (T2) and 1 year (T3) after surgery.Results 
    A cross-lagged path analytic model showed that an increase in depressive symptoms predicted a decrease in physical functioning (βT1-T2 = −0.15 [P < .001]; βT2-T3 = −0.17 [P < .001]), but not the other way around. Multigroup comparisons revealed one moderator effect: in patients with systolic heart failure (left ventricular ejection fraction [LVEF], ≤45%), the effect of depression on physical functioning from T2 to T3 was significantly stronger than in patients with preserved LVEF (βT2-T3 = −0.30 [P < .001] vs βT2-T3 = −0.14 [P < .001]; χ2diff = 3.885 [P = .049]).Conclusions 
    More attention should be paid to diagnosis and treatment of depression in patients undergoing CABG. After surgery, patients with systolic heart failure and depressive symptoms in particular seem at risk of a deterioration of their physical functioning.