FREQUENCY OF DEPRESSION AMONG PATIENTS WITH ACUTE CORONARY SYNDROME, EASTERN REGION, SAUDI ARABIA

BACKGROUND: Three decades ago, Epidemiologists began to report a strong association between depression and cardiovascular disease - morbidity and mortality, and in the last decade, many large-scale studies have identified depression as an important risk factor for Coronary Artery Disease (CAD) and its morbidity and mortality. OBJECTIVES: To determine the frequency of clinical depression among patients admitted with Acute Coronary Syndrome (ACS) to the Coronary Care Unit (CCU) at King Fahd Hospital of the University (KFHU), and to find out if there is any relationship between depression and the traditional risk factors for CAD. METHODS: One hundred and two patients admitted consecutively with ACS completed the self-rated Beck Depression Inventory (BDI) in their native language. The patients were classified into two groups: Group A comprising patients with no symptoms of depression and patients with subclinical or borderline depression, scored less than 21 points on BDI score scale; and Group B composed of those who scored 21 points and above. Various statistical tests were used whenever appropriate. RESULTS: One hundred and two patients completed the BDI. Ninety-Two (90.2%) were males, with a mean age of 52.14±12.14 years. Of these, 37.3% were Saudis, 25.5% Non-Saudi Arabs, 31.4% from the Indian subcontinent and 5.9% were other Asians. Patients from the Indian Subcontinent were significantly younger than the Saudis (p<0.0001). The evidence of clinical depression was found in 20.6% of all patients, 13.2% of Saudi patients, 19.2% of Non-Saudi Arabs and 34.4% of those from the Indian subcontinent. There was a significant difference in the frequency of clinical depression between Saudi patients and the Indians (p=0.035). Smoking and dyslipidemia were the only strong predictors of clinical depression in our study. CONCLUSION: Depression is unquestionably associated with CAD. Its frequency in our patients with ACS was 20.6%, and the highest frequency was recorded among patients from the Indian subcontinent (34.4%). Smoking and dyslipidemia were the strongest independent risk factors for depression.