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Published online before print November 13, 2006
Psychosom Med 2006, doi:10.1097/01.psy.0000244391.56598.10
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© 2006 by American Psychosomatic Society

Original Article


Received February 6, 2006
Returned for revision June 20, 2006
Accepted ,

Course of Depressive Symptoms in Patients Undergoing Heart Surgery: Confirmatory Analysis of the Factor Pattern and Latent Mean Structure of the Center for Epidemiologic Studies Depression Scale

Richard J. Contrada , PhD, David A. Boulifard , PhD, Ellen L. Idler , PhD, Tyrone J. Krause , MD, Erich W. Labouvie , PhD


Address correspondence and reprint requests to: Richard J. Contrada, PhD, E-mail: contrada{at}rci.rutgers.edu.


  Abstract

Objective: The purpose of this study was to examine the dimensionality, stability, and course of depressive symptoms over the 12-month period beginning approximately 1 week before heart surgery. Methods: The Center for Epidemiological Studies Depression Scale (CES-D) was administered to 570 patients before heart surgery and 1, 3.5, 6.5, and 12.5 months later. Results: Confirmatory factor analysis rejected a four-factor model as a result of small variances for two interpersonal items. With their elimination, a three-factor solution (negative affect, low positive affect, somatic/vegetative symptoms) showed good psychometric properties. Except for the somatic/vegetative factor at the 1-month follow up, there was a high degree of stability in the factor pattern over a 12-month period beginning approximately 1 week before heart surgery. Latent mean structure analysis indicated that, apart from elevations in several somatic/vegetative symptoms during the month after surgery, means for all three depressive symptoms declined over time. The recovery of positive affect showed a steeper trajectory toward the end of the follow-up period by comparison with the rates of decline for depressed affect and somatic/vegetative symptoms. Conclusions: These findings support using 18 CES-D items to measure three depressive symptom dimensions in heart patients and may reflect a normative pattern of adjustment to heart surgery.

Key Words: Center for Epidemiologic Studies Depression Scale, depressive symptoms, coronary artery bypass graft surgery, valve surgery, confirmatory factor analysis, latent mean structure analysis




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[Abstract] [Full Text] [PDF]


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Copyright © 2006 by the American Psychosomatic Society