Observational Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatr. Jun 22, 2017; 7(2): 106-113
Published online Jun 22, 2017. doi: 10.5498/wjp.v7.i2.106
Childhood trauma and factors associated with depression among inpatients with cardiovascular disease
Felipe José Nascimento Barreto, Frederico Duarte Garcia, Paulo Henrique Teixeira Prado, Paulo Marcos Brasil Rocha, Nádia Souza Las Casas, Felipe Barbosa Vallt, Humberto Correa, Maila Castro Lourenço Neves
Felipe José Nascimento Barreto, Frederico Duarte Garcia, Nádia Souza Las Casas, Felipe Barbosa Vallt, Maila Castro Lourenço Neves, Department of Mental Health, Federal University of Minas Gerais, Avenida Alfredo Balena, CEP 30130-100 Belo Horizonte, Brazil
Felipe José Nascimento Barreto, Postgraduation Program in Molecular Medicine, School of Medicine, Federal University of Minas Gerais, Avenida Alfredo Balena, CEP 30130-100 Belo Horizonte, Brazil
Frederico Duarte Garcia, Humberto Correa, Molecular Medicine National Institute of Science and Technology, Avenida Alfredo Balena, Federal University of Minas Gerais, CEP 30130-100 Belo Horizonte, Brazil
Paulo Henrique Teixeira Prado, Paulo Marcos Brasil Rocha, Hospital das Clínicas, Federal University of Minas Gerais, Avenida Alfredo Balena, CEP 30130-100 Belo Horizonte, Brazil
Author contributions: Barreto FJN, Garcia FD, Prado PHT, Rocha PMB, Correa H and Neves MCL contributed to the conception of the study and design; Barreto FJN, Las Casas NS and Vallt FB contributed to data acquisition and interpretation, and writing of the paper; Garcia FD and Neves MCL contribute to editing, reviewing and final approval of the paper.
Supported by the program of Young Researchers of the Federal University of Minas Gerais, No. 01/2013; and FAPEMIG (Fundação de Amparo a Pesquisa do Estado de Minas Gerais, Brazil), No. APQ-01714-13. The funder did not interfere with any procedure regarding the production of this paper.
Institutional review board statement: The Committee of Ethics in Research of UFMG approved the protocol, registered with the number CAAE 13605213.3.0000.5149.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrolment.
Conflict-of-interest statement: Garcia FD received CME grants, received paid speakership, and participated in research from Janssen and Pfizer; Correa H received paid speakership, and participated in research from Janssen; Prado PHT and Neves MCL participated in research from Janssen. The other authors have no conflicts to declare.
Data sharing statement: We would like to inform that, related to the research described on our manuscript, no additional data is available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Maila Castro Lourenço Neves, Department of Mental Health, Federal University of Minas Gerais, Avenida Alfredo Balena, 190 - Sala 240, CEP 30130-100 Belo Horizonte, Brazil. mailacln@ufmg.br
Telephone: +55-31-34099786
Received: January 21, 2017
Peer-review started: January 21, 2017
First decision: February 15, 2017
Revised: March 30, 2017
Accepted: April 23, 2017
Article in press: April 24, 2017
Published online: June 22, 2017
Processing time: 152 Days and 5.7 Hours
Abstract
AIM

To identify factors associated with depressive symptoms among inpatients with cardiovascular disease (CVD).

METHODS

This is a cross-sectional study performed in a subsample of a large cross-sectional research that investigated affective disorders and suicide behaviour among inpatients hospitalized in non-surgical wards of the University Hospital of the Federal University of Minas Gerais from November 2013 to October 2015. Sociodemographic and clinical data were obtained through a structured interview and medical record review. Depression was assessed by the depression subscale of the Hospital Anxiety and Depression Scale, with scores ≥ 8 considered as positive screening for depression. We used the Fageström Test for Nicotine Dependence to characterize nicotine dependence. For assessing resilience and early-life trauma, we used the raw scores of the Wagnild and Young Resilience Scale and Childhood Trauma Questionnaire, respectively.

RESULTS

At endpoint, we included 137 subjects. Thirty-eight (27.7%) subjects presented depressive symptoms and nine (23.7%) of those were receiving antidepressant treatment during hospitalization. The female sex; a lower mean educational level; a greater prevalence of previous suicide attempts; a higher level of pain; a higher prevalence of family antecedents of mental disorders; a lower resilience score; and higher childhood trauma score were the factors significantly associated with screening positive for major depression (P < 0.05). Multivariate analysis demonstrated that the factors independently associated with the depressive symptoms were a higher childhood trauma severity (OR = 1.06; P = 0.004); moderate to severe nicotine dependence (OR = 8.58; P = 0.008); and the number of previous hospital admissions (OR = 1.11; P = 0.034). The obtained logistic model was considered valid, indicating that the three factors together distinguished between having or not depressive symptoms, and correctly classified 74.6% of individuals in the sample.

CONCLUSION

Our results demonstrate that inpatients presenting both CVD and a positive screening for depression are more prone to have antecedents of childhood trauma, nicotine dependence and a higher number of previous hospitalizations.

Keywords: Inpatients; Depression; Cardiovascular disease; Depressive symptoms; General hospital

Core tip: The prevalence of depression is considerably higher among individuals with cardiovascular diseases (CVD) when compared to the general population. Both major depression and depressive symptoms are predictors of poor outcome in patients with CVD. Depressive disorder is frequently overlooked and untreated in individuals with CVD. Our results demonstrate that inpatients presenting both CVD and a positive screening for depression are more prone to have antecedents of childhood trauma, nicotine dependence and a higher number of previous hospitalizations. Clinicians may consider these factors in the assessment of CVD inpatients at risk for major depression. This measure can improve their treatment approach and patients’ prognosis.