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Effects of depression co-morbidity and treatment on quality of life in patients with acute coronary syndrome: the Korean depression in ACS (K-DEPACS) and the escitalopram for depression in ACS (EsDEPACS) study

Published online by Cambridge University Press:  21 November 2014

J.-M. Kim ,
R. Stewart ,
K.-Y. Bae ,
H.-J. Kang ,
S.-W. Kim ,
I.-S. Shin ,
Y. J. Hong ,
Y. Ahn ,
M. H. Jeong  and
J.-S. Yoon
J.-M. Kim*
Affiliation:
Department of Psychiatry, Chonnam National University Medical School, and Depression Clinical Research Center, Chonnam National University Hospital, Gwangju, Korea
R. Stewart
Affiliation:
Institute of Psychiatry, King's College London, London, UK
K.-Y. Bae
Affiliation:
Department of Psychiatry, Chonnam National University Medical School, and Depression Clinical Research Center, Chonnam National University Hospital, Gwangju, Korea
H.-J. Kang
Affiliation:
Department of Psychiatry, Chonnam National University Medical School, and Depression Clinical Research Center, Chonnam National University Hospital, Gwangju, Korea
S.-W. Kim
Affiliation:
Department of Psychiatry, Chonnam National University Medical School, and Depression Clinical Research Center, Chonnam National University Hospital, Gwangju, Korea
I.-S. Shin
Affiliation:
Department of Psychiatry, Chonnam National University Medical School, and Depression Clinical Research Center, Chonnam National University Hospital, Gwangju, Korea
Y. J. Hong
Affiliation:
Department of Cardiology, Chonnam National University Medical School, and Depression Clinical Research Center, Chonnam National University Hospital, Gwangju, Korea
Y. Ahn
Affiliation:
Department of Cardiology, Chonnam National University Medical School, and Depression Clinical Research Center, Chonnam National University Hospital, Gwangju, Korea
M. H. Jeong
Affiliation:
Department of Cardiology, Chonnam National University Medical School, and Depression Clinical Research Center, Chonnam National University Hospital, Gwangju, Korea
J.-S. Yoon
Affiliation:
Department of Psychiatry, Chonnam National University Medical School, and Depression Clinical Research Center, Chonnam National University Hospital, Gwangju, Korea
*
* Address for correspondence: J.-M. Kim, M.D., Ph.D., Department of Psychiatry, Chonnam National University Medical School, 160 Baekseoro, Dong-gu, Gwangju, 501–746, Republic of Korea. (Email: [email protected])
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Abstract

Background

Depression is common after acute coronary syndrome (ACS) with adverse effects on prognosis. There is little evidence on whether depression treatment improves quality of life (QoL) in ACS patients. The aim of this study was to investigate the effects of co-morbid depression and its treatment on QoL in ACS.

Method

In total, 1152 patients were recruited at baseline, 2–14 weeks after a confirmed ACS episode, and 828 were followed 1 year thereafter. Of 446 baseline participants with co-morbid depressive disorders, 300 were randomized to a 24-week double blind trial of escitalopram or placebo, while the remaining 146 received medical treatment only (MTO). QoL was measured by the World Health Organization Quality of Life –Abbreviated form (WHOQOL-BREF).

Results

At baseline, QoL was significantly lower in patients with co-morbid depressive disorder than those without. QoL improvement was significantly greater in those receiving escitalopram than those receiving placebo over the 24-week treatment period. In the 1-year follow-up, the better outcomes associated with escitalopram remained evident against both placebo and MTO.

Conclusions

Depression was significantly associated with worse QoL even in patients with recently developed ACS. Depression treatment was associated with QoL improvement in ACS patients in the 24-week treatment period, the effects of which extended to 1 year.

Keywords

Acute coronary syndromedepressionlongitudinal studyquality of liferandomized controlled trial
Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 8 , June 2015 , pp. 1641 - 1652
Copyright
Copyright © Cambridge University Press 2014 

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