The Nature of the Depressive Symptomatology Preceding Myocardial Infarction

Abstract

Little is known about the nature of the depressive symptomatology preceding myocardial infarction (MI). Specification of the depressive symptomatology is important for the development of hypotheses about the biological mechanisms relating depressive symptoms to MI. To test the hypothesis that feelings of fatigue and loss of energy have the strongest predictive power of all depressive symptoms, the authors reanalyzed data from a prospective study of 3877 healthy men aged 40 to 65 years. The men's mental state was assessed using the Maastricht Questionnaire, a scale that measures vital exhaustion, which is characterized by unusual fatigue and lack of energy, increased irritability, and depressive symptoms, including demoralization. Oblique factor analysis was used to validate these dimensions. Results of Cox's regression analyses showed that the fatigue subscale has the strongest predictive power for incident MI and that depression and irritability subscales lose their predictive power when controlled for fatigue.

Index Terms:

• Index Terms
• fatigue
• HPA axis
• myocardial infarction
• vital exhaustion

Additional information

Notes on contributors

Ad Appels

Dr Appels is a professor of medical psychology in the Department of Medical Psychology at the University of Maastricht in Maastricht, The Netherlands; Dr Kop is a research assistant professor of medical and clinical psychology in the Department of Medical and Clinical Psychology at the Uniformed Services University of the Health Sciences in Bethesda, Maryland; and Mr Schouten is a statistical analyst in the department of Medical, Clinical, and Experimental Psychology at the University of Maastricht.