Social support deficit and depression treatment outcomes in patients with acute coronary syndrome: Findings from the EsDEPACS study

Abstract

Objectives This study aimed to investigate whether social support deficit has moderating effects on depressive and cardiac outcomes in an antidepressant trial for depressed patients with acute coronary syndrome as a secondary analysis using Escitalopram for DEPression in acute coronary syndrome study (ClinicalTrial.gov registry number: NCT00419471). Methods In total, 217 acute coronary syndrome patients with Diagnostic and Statistical Manual of Mental Disorders, 4th edition depressive disorders were randomized into two groups that received escitalopram (N = 108) or placebo (N = 109) for 24 weeks. Social support deficit was evaluated by validated scales at study entry. Depressive outcomes were measured using the Hamilton Depression Rating Scale, the Montgomery Asberg Depression Rating Scale, and the Beck Depression Inventory. Cardiac outcomes included echocardiography (left ventricular ejection fraction and wall motion scores), electrocardiography (heart rate, PR interval, QRS duration, and QTc duration), and laboratory test results (troponin I and creatine kinase-MB). Results A higher social support deficit at baseline was significantly associated with less improvement in Hamilton Depression Rating Scale, Montgomery Asberg Depression Rating Scale, Beck Depression Inventory scores, and serum troponin I levels after adjustment for corresponding baseline scores, covariates associated with social support deficit at baseline, and treatment status. The strength of these associations was more prominent in the placebo group compared to the escitalopram group. Conclusions Evaluation of social support deficit in depressed acute coronary syndrome is important, and particularly during the acute phase, depressed acute coronary syndrome patients with social support deficit should be treated more carefully to improve treatment outcomes, given that social support deficit was predictive of poorer depressive and cardiac outcomes during the 24-week treatment period. Acute coronary syndrome patients with social support deficit should be treated more carefully to improve treatment outcomes.

The association between social ties and changes in depressive symptoms among veterans enrolled in a collaborative depression care management program.

“…Individuals with depression are at higher risk of being socially isolated and experiencing feelings of rejection, which may further exacerbate depressive symptoms (Starr & Davila, 2008). Moreover, there is evidence to suggest that short-term behavioral interventions that do not address or utilize patients’ social contexts and resources may have little long-term impact (George et al, 1989; Kamenov et al, 2017; Kim et al, 2019). Accordingly, our finding that greater social contact was significantly associated with larger reductions in depressive symptoms over the course of care management can help inform future clinical research endeavors.…”

“…Social support is also associated with improved depression treatment outcomes (Hallgren et al, 2017; Wang, Mann, Lloyd-Evans, Ma, & Johnson, 2018). There is strong evidence, for instance, that higher perceived social support is associated with lower symptom severity, better recovery and remission rates, and better functional outcomes at follow-up among individuals with depression (Hallgren et al, 2017; Kim et al, 2019; Oxman & Hull, 2001; Wang et al, 2018).…”

Criticism in the Parkinson’s Caregiving Relationship: A Key Target for Intervention

“…22,[37][38][39][40][41] Conversely, there is strong evidence for the association between supportive relationships and lower symptom severity, better recovery and remission rates, and better functional outcomes at follow-up among individuals with depression. [42][43][44][45] Thus, the importance of better understanding patterns of critical exchanges between individuals with comorbid PD and depression and their CPs is particularly salient.…”

“…For example, while some reports indicate no difference in overall burden between adult child versus spousal caregivers, 50 others report that spousal caregivers experience greater burden and distress than adult child caregivers. 43,51,52 Potential explanations include the salience of the marital relationship, emotional distress associated with the potential loss of a spouse, and greater reluctance in seeking community and outside services and assistance with care. 53,54 The current study has several limitations worth noting.…”

Effects of WeChat platform-based health management on health and self-management effectiveness of patients with severe chronic heart failure

“…Patients frequently need to be hospitalized, which may not only lead to deterioration of their condition, but also add an economic burden on them, causing medical resource waste. Therefore, maintaining a stable condition of chronic heart failure has become a key objective in clinical treatments[ 1 ]. However, the phenomena of worsening cardiac situations and repeated hospitalizations are currently very common given that there are no effective approaches to address the issues of health intervention subsequent to the discharge of patients and their poor self-management capabilities.…”