Anxiety and depression following myocardial infarction: gender differences in a 5-year prospective study

Objective: The aim of this study was to examine the impact of the first myocardial infarction (MI) and the relative influence of preexisting confounding factors on anxiety and depression in the following 5 years. Methods: A total of 23,693 participants, 35 - 79 years of age at baseline, attended two population-based prospective studies in 1984-1986 and in 1995-1997. They underwent physical examination and self-reported demographic, lifestyle, psychosocial, and medical health characteristics in both surveys. Outcome measure was the Hospital Anxiety and Depression rating Scale (HADS). Results: Five hundred twelve participants suffered their first MI in the last 5 years before follow-up. Women showed an increased risk for both anxiety and depression in the first 2 years post-MI, followed by a significant symptom reduction. In contrast, the risk for depression in men increased after 2 years post-MI. Anxiety and depression, low educational level, obesity, daily smoking, and physical inactivity pre-MI significantly predicted a poor psychiatric outcome at follow-up. Conclusion: Five-year follow-up after MI revealed gender-specific outcomes of anxiety and depression not previously described. (c) 2005 Elsevier Inc. All rights reserved.