Korean Circ J.  2021 Sep;51(9):752-763. 10.4070/kcj.2021.0009.

Community-Dwelling Individuals with Coronary Artery Disease Have Higher Risk of Depression than the General Population in Female, But Not in Male

Affiliations
  • 1Division of Cardiology, Department of Internal Medicine, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Korea
  • 2Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea
  • 3Department of Preventive Medicine & Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea
  • 4Department of Nursing, Chonnam National University, Gwangju, Korea

Abstract

Background and Objectives
The aim of this study was to assess sex difference in the association between coronary artery disease (CAD) status and depression in a representative nationwide Korean population.
Methods
In total, 4,620 male and 6,151 female aged ≥40 years, who participated in the Korea National Health and Nutrition Examination Survey conducted in 2014, 2016, and 2018, were included in the analysis. Depression was defined as ≥10 points on the 9-item Patient Health Questionnaire.
Results
Among male participants, no significant association between CAD status and depression was observed. However, female with CAD had higher odds ratio (OR) for depression (OR, 2.68; 95% confidence interval [CI], 1.78–4.03) compared with those without CAD in a multiple logistic regression analysis after adjustment for covariates. Younger age at diagnosis of CAD was a significant relating factor for depression in female; OR (95% CI) was 1.73 (0.88–3.40), 3.01 (1.52–5.97), and 4.11 (2.04–8.28) for age ≥65 years, 55–64 years, and ≤54 years, respectively, compared with that in non-CAD controls. In addition, shorter duration of CAD was a significant relating factor for depression in female; OR (95% CI) was 2.42 (1.26–4.67), 2.61 (1.32–5.16), and 3.13 (1.54–6.34) for duration ≥10 years, 5-9 years, and ≤4 years, respectively, compared with that in non-CAD controls.
Conclusions
Consistent screening and psychosocial supports for depression after discharge are required to improve the mental health care of CAD survivors in the community, especially for female diagnosed at a younger age and recently diagnosed.

Keyword

Coronary artery disease; Depression; Patient Health Questionnaire; Community
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