Longitudinal course of depressive symptomatology after a cardiac event: effects of gender and cardiac rehabilitation.

Objective: Recent research has linked depression to cardiac mortality, and shown a high burden of persistent depressive symptomatology among cardiac patients. The objective of this study was to longitudinally examine the prevalence and course of depressive symptomatology among women and men for 1 year after a cardiac event, and the effect of cardiac rehabilitation (CR) on this trajectory.

Methods: Nine hundred thirteen unstable angina (UA) and myocardial infarction patients from 12 coronary care units were recruited, and follow-up data were collected at 6 and 12 months.

Prospective examination of anxiety persistence and its relationship to cardiac symptoms and recurrent cardiac events.

Background: The current study builds on previous research demonstrating a link between anxiety and inhospital recurrent ischemic and arrhythmic events, by examining the effects of persistent anxiety on recurrent events 1 year later.

Methods: 913 patients with unstable angina (UA) and myocardial infarction (MI) from 12 coronary care units were recruited, and follow-up data were collected at 6 and 12 months after the event. Measures included cardiac symptomatology, healthcare utilization, the anxiety subscale of the Primary Care Evaluation of Mental Disorders , the phobic anxiety subscale of the Middlesex Hospital Questionnaire, and the Beck Depression Inventory.

Sex differences in predictors of illness intrusiveness 1 year after a cardiac event.

Objective: This prospective study examined sex differences in illness intrusiveness and in baseline predictors of illness intrusiveness in cardiac patients' 1-year postcardiac event.

Methods: Patients diagnosed with a myocardial infarction (MI) or unstable angina (UA) completed a baseline questionnaire during their hospitalization (139 men and 104 women). Eighty-one men and 67 women completed the follow-up questionnaire 1-year postcardiac event.

Gender differences in health information needs and decisional preferences in patients recovering from an acute ischemic coronary event.

Objective: This study examined gender differences in health information needs and decisional preferences after an acute ischemic coronary event (ICE).

Methods: Patients with ICE, recruited in 12 coronary intensive care units, completed a questionnaire on demographic, disease-related, and psychosocial topics. Six and 12 months later, they completed mailed follow-up questionnaires.

Presentation, delay, and contraindication to thrombolytic treatment in females and males with myocardial infarction.

Background: This study seeks to explore gender-relevant factors of medical history, sociodemographics, symptom presentation, and delay on thrombolysis administration (or recorded contraindication) in a sample of men and women with confirmed myocardial infarction (MI).

Methods: Cross-sectional examination of self and nurse-report data collected in the coronary care unit (CCU) from 12 hospitals across south-central Ontario, Canada. A total of 482 MI patients (347 males, 135 females; 63% response rate) were recruited.

Cardiac rehabilitation II: referral and participation.

Cardiovascular disease (CVD) is the leading cause of death and disability for women and men. Substantial health risks continue following ischemic coronary events (ICEs), but secondary prevention efforts, including cardiac rehabilitation (CR), have beneficial effects on both early and late mortality and morbidity. This prospective study examined the relationship among psychosocial factors and CR referral and participation patterns in 906 (586 men, 320 women) patients from the coronary intensive care unit (CICU) over the course of six months.

Cardiac rehabilitation I: review of psychosocial factors.

Cardiovascular disease (CVD) is the leading cause of death and disability for women and men. There are gender differences in recovery from coronary events, which may be due physiological, sociodemographic, or psychosocial factors. Cardiac rehabilitation programs have beneficial effects on coronary recovery.

Psychological factors and depressive symptoms in ischemic heart disease.

The aim of this study was to determine whether learned helplessness, cognitive distortions, self-efficacy, and dispositional optimism assessed at Time 1 (T1; questionnaires mailed at 1 month postdischarge) would predict depressive symptoms at Time 2 (T2; questionnaires mailed at 1-year follow-up) in a sample of 86 patients hospitalized with ischemic heart disease. Multiple regression results indicated that optimism and cognitive distortions at T1 were significantly associated with T1 depressive symptoms after controlling for confounding variables. When the T1 psychological factors were analyzed with T2 depressive symptoms, only optimism continued to predict depressive symptoms after controlling for confounds and T1 depressive symptoms.

A critical review of research related to family physician-assisted smoking cessation interventions.

A review of family physician-assisted smoking cessation research indicates that the family practice setting affords an excellent opportunity to intervene with a large proportion of smokers, at a time when they are receptive to health promotion messages. Outcome data at 6- and 12-month follow-up intervals indicate the value of combining 3 key strategies in achieving optimal results: physician advice and support, nicotine replacement therapy, and cognitive-behavioural counselling. The authors' review identifies questions that need to be addressed in future research: How can barriers to program delivery be overcome in the family practice setting? What is the best way to ensure optimal integration of the 3 key strategies? Which follow-up intervals are appropriate (e.

Helplessness, self-efficacy, cognitive distortions, and depression in multiple sclerosis and spinal cord injury.

The aim of this study was to determine if learned helplessness, self-efficacy, and cognitive distortions would predict depression in a sample of 80 individuals with multiple sclerosis (MS) and 80 individuals with a spinal cord injury (SCI). As MS and SCI usually present with disparate disease courses and etiologies, a secondary objective was to determine if individuals with MS would exhibit greater levels of helplessness, cognitive distortions, and depression and lower levels of self-efficacy than those with SCI. Results indicated that helplessness and self-efficacy significantly predicted depression for both the MS and SCI groups after controlling for confounding variables.

Stress, Multiple Sclerosis, and Everyday FunctioningA Review of the Literature with Implications for Intervention.

Numerous studies have described an association between stress and the onset or exacerbation of multiple sclerosis (MS). Most of the studies that have been conducted to date, however, have had methodological flaws including: (1) retrospective designs, (2) inadequate or absent control groups, (3) small sample sizes, (4) clinical measures that are insensitive to underlying disease activity, and (5) wide variation in the measurement of stress. Animal models of MS have enabled researchers to examine the effects of stress directly in the central nervous system.