Depression and prehospital delay in the context of myocardial infarction

Objective: The purpose of this study was to evaluate how depression Might influence treatment-seeking behaviors in the context of evolving symptoms of myocardial infarction (MI). Methods: Post-MI patients (n = 433) completed a retrospective self-report measure of depressive symptoms with regard to the 2 weeks preceding the MI and a semistructured interview regarding their treatment-seeking behaviors. Results: Survival analyses found that delay in seeking treatment for acute MI symptoms was observed among participants who (1) attributed their symptoms to noncardiac causes, (2) perceived their symptoms to be relatively mild, (3) experienced gastrointestinal distress, (4) did not experience sweating, and (5) reported being depressed during the 2 weeks before hospitalization. Subsidiary analyses indicated that, among depressive symptoms, sleep disturbance and fatigue predicted delay. Conclusion: Depression warrants further attention as a variable that may influence treatment seeking for MI symptoms. Results highlight the need to adequately screen for and treat depression among persons at risk for MI.