Table 4 Summary of effect of depression predicting likelihood of RTW post-MI at 6-8 and 12-13 months
Author | Finding | Ratio | Depression severity | Estimate of relative risk | CI (95%) | P value | Variables included in multivariate analysis** (bold indicates significance) |
|---|---|---|---|---|---|---|---|
DEPRESSION SIGNIFICANTLY PREDICTED RTW | |||||||
6-8 MONTHS | Â | Â | Â | Â | Â | Â | Â |
Fukuoka (2009)[28] | As a time-dependent covariate, increases in depression score predicted slower RTW at 6 months | Adjusted Hazard ratio* | Moderate depression Severe depression | 0.47 0.37 | 0.31-0.72 0.21-0.66 | < 0.001 0.001 | Age, sex, nationality, education, income, marital status, smoking, hyperlipidemia, Duke activity index score (physical functioning), job strain, job satisfaction, job security, working hours per week, shift work, social support (from supervisor, co-workers) |
Samkange-Zeeb (2006)[29] | Level of depression was significant predictor of RTW at 6 months | Adjusted Odds ratio | Borderline depression Clinical depression | 0.62 0.28 | 0.35-1.12 0.14-0.58 | Â | Age, sex, profession, anxiety, expectations about work incapacity and desire to RTW |
Soejima (1999)[31] | Depressed patients less likely to RTW at 8 months | Adjusted Odds ratio | Â | 0.15 | 0.02-0.87 | < 0.031 | Age, education, occupation, personality type health locus of control |
12-13 MONTHS | Â | Â | Â | Â | Â | Â | Â |
McGee (2006)[35] | Baseline depression significantly predicted RTW at 12 months | Adjusted Odds ratio | HADS depression | 0.2 | 0.06-0.6 | 0.007 | Prior ACS, age and sex |
Sykes (2000)[32] | Depression significant predictor of RTW at 12 months | Wald test | Â | 7.335 (df = 1) | Â | 0.0068 | Decision latitude, work social interaction, age, medical prognosis (Coronary Prognostic Index) |
Samkange-Zeeb (2006)[29] | Level of depression was significant predictor of RTW at 12 months | Adjusted Odds ratio | Borderline depression Clinical depression | 0.35 0.24 | 0.18-0.68 0.11-0.49 | Â | Age, sex, profession, anxiety, expectations about work incapacity and desire to RTW |
Soderman (2003) [5] | Clinical depression (BDI >16) predicted RTW at 12 months | Adjusted Odds ratio | Clinical depression Mild depression Clinical depression Mild depression | 9.43 (fulltime) 2.89 (fulltime) 5.44 (reduced hours) OR not shown | 3.15-28.21 1.08-7.70 1.60-18.53 | <0.001 0.0300 <0.0068 0.7848 | Gender, age, education, exercise capacity |
Bhattacharyya (2007) [14] | Every increase in BDI index reduced likelihood of RTW at 12-13 months | Adjusted Odds ratio | Â | 0.90 | 0.82-0.99 | 0.032 | Age, gender, risk of cardiac event, heart failure, antidepressant use, Arrhythmia during admission, recurrent cardiac events |
DEPRESSION DID NOT SIGNIFICANTLY PREDICT RTW | Â | Â | Â | ||||
6-12 MONTHS | Significant predictors | Â | Â | Â | |||
Brink [30] | Somatic health better predictor of RTW than mental health at 6 months | Adjusted Odds ratio | Physical health component score Footsteps per day | 1.08 1.18 | 1.02-1.14 1.01-1.38 | 0.011 0.033 | Physical health, age, footsteps per day |
Ladwig (1994) [34] | Depression as a significant predictor of RTW at 6 months (OR: 0.39, Cl 0.18-0.88), was lost after adjustment for age, social class, rehabilitation, recurrent infarction, cardiac events, helplessness (OR: 0.54 CI 0.22-1.31) | Â | - | Â | Â | Â | Â |
Mayou (2000) [9] | No significant differences in RTW between distressed and nondistressed at 12 months | Â | - | Â | Â | Â | Â |
Engblom [27] | At 12 months, patients' expectations of work, duration of absence from work before CABS and physical capacity of patients after surgery are important determinants of RTW after CABS | Adjusted Odds ratio | Self assessed work capacity at six months (Good vs Poor) Functional Class (Canadian CVD class I vs II-III) Patient expectation about work (RTW vs retire) Absence from work before the CABS (3 months or less) | 8.5 6.7 6.4 4.9 | 2.3-32.0 1.8-24.5 1.6-26.0 1.2-20.2 | 0.003 0.006 0.013 0.032 | Type of rehabilitation, previous MI, expectations regarding work, physical strain of work, duration of the preoperative absence from work, basic education, professional education, socioeconomic status, preoperative BDI score, final work load at exercise test, functional class, patients' perception of working capacity at 6 months after the CABS. |
Mittag [33] | Three variables predicted RTW at 12 months in 85% of all cases: (1) age, (2) patients' feelings about disability (3) physicians' views on the extent to which vocationally disabled | Adjusted Odds ratio | Age Self perceived disability Physician's view of disability | 1.22 3.02 1.61 | 1.10-1.34 2.48-3.57 1.16-2.07 | <0.01 <0.001 <0.05 | Results of exercise testing, optimistic coping style, family income, negative incentives for RTW, physicians' subjective prognosis as to re-employment, patients' wish to return to work, age, self perceived vocational disability, physician's perception of patient disability. |