Which Factors Unexpectedly Increase Depressive Symptom Severity in Patients at the End of a Cardiac Rehabilitation Program?

OBJECTIVE: To investigate predictors of depressive symptom aggravation at the end of a cardiac rehabilitation (CR) program. METHODS: The design of the study was retrospective. The administrative data were obtained from the database of the CR department of a heart hospital in Iran. The demographic and clinical information of 615 CR patients between January 2000 and January 2010 was analyzed using binary logistic regression analysis. RESULTS: The results showed that 10.7% of the patients completed the CR program with aggravated depressive symptoms. After adjustment for gender, age, and pre-intervention depression score, lower education level (p<0.05) and smoking (p<0.01) were significant predictors of increased depressive symptoms at the end of the program. Our model variables could explain 6% to 13% of the dependent variable variance. CONCLUSION: The results suggest that targeting patients who are less literate or who smoke could allow for taking the required measures to prevent or control depression at the end of a CR program. It is suggested that future studies consider other variables.