VANCOUVER, B.C. — Symptoms of depression predict increases in intima-media thickness, Jesse C. Stewart, Ph.D., reported at the annual meeting of the American Psychosomatic Society.
Intima-media thickness (IMT), a measure of the thickness of the intima and medial layers of the carotid artery wall, is a marker of subclinical atherosclerosis and has been shown to predict future coronary events, said Dr. Stewart, of the department of psychiatry, University of Pittsburgh.
Data from 357 healthy adult (mean age 60 years) participants in the Pittsburgh Healthy Heart Project suggest that the somatic-vegetative symptoms—such as loss of pleasure, crying, agitation, and changes in appetite—significantly predict 3-year changes in IMT, whereas cognitive-affective symptoms such as sadness, pessimism, and guilty feelings do not, Dr. Stewart said.
Ultrasound images were obtained of the right and left carotid arteries at baseline and again at 3 years. The average 3-year change in IMT—computed as the mean of the sum of the far wall measurements from the common carotid, internal carotid, and bulb regions—was 0.09 mm for the group as a whole.
After adjustment for age, sex, and race, higher scores on the Beck Depression Index-II (BDI-II) at baseline were significantly associated with greater increases in carotid IMT. Average changes were 0.11 mm for participants in the highest BDI-II quartile, compared with 0.06 mm among those in the lowest quartile, he reported.
In contrast, 3-year changes in IMT were not predicted by scores on the Cook-Medley Hostility Scale or the Beck Anxiety Inventory.
When specific items on the BDI-II were examined, the somatic-vegetative or physical symptoms of depression explained nearly all of the differences in IMT scores, whereas the cognitive-affective factors alone were not predictive of early heart disease.
Previous prospective studies have demonstrated that depression, hostility, and anxiety all increase the risk for cardiovasular disease (CVD), but few have simultaneously examined the influence of all three factors, Dr. Stewart said.