Intra-individual changes in anxiety and depression during 12-month follow-up in percutaneous coronary intervention patients

Background: Only a paucity of studies focused on intra-individual changes in anxiety and depression over time and its correlates in cardiac patients, which may contribute to the identification of high-risk patients and point to targets for intervention. We examined changes in anxiety and depression over a 12-month period and the demographic and clinical correlates of change scores using an intra-individual approach in patients treated with percutaneous coronary intervention (PCI). Methods: Consecutive PCI patients (N=715) completed the Hospital Anxiety and Depression Scale (HADS) at baseline and at 12 months post-PCI. Individual change scores were calculated and in secondary analysis, three categories of change were identified (i.e., stable, improved, and deteriorated anxiety or depression). Results: The mean individual change was -.16 (+/- 3.0) for anxiety and -.02 (+/- 2.8) for depression. In linear regression analysis, baseline anxiety levels (B = -.25, 95%CI[-.30 to -.20], p=<.001) and baseline depression levels (B = -.28, 95%CI[-.33 to -.22], p=<.001) were significant correlates of individual change scores. Secondary analysis showed that anxiety remained stable in 76.4% (546/715) of patients, while depression remained stable in 81.4%. (582/715) of patients. Conclusions: The findings of the current study showed that levels of anxiety and depression remained stable in the majority of PCI patients from the index PCI to 12 months post-PCI. Future studies using an intra-individual approach are warranted to further examine individual changes in anxiety and depression over time in CAD, and PCI in particular, as a means to bridge the gap between research and clinical practice. (C) 2011 Elsevier B.V. All rights reserved.