Predictive relationship between depression and physical functioning after coronary surgery.

摘要

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 (beta(T)(T) = -0.15 [P < .001]; beta(T)(T)= -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],