Akihiro Yamashita1, Hiroko Noguchi2, Kei Hamazaki3, Yasuhiro Sato4, Tomomi Narisawa5, Yuzuru Kawashima6, Masato Usuki7, Daisuke Nishi8, Haruo Yoshimasu9, Naoshi Horikawa9, Yutaka J Matsuoka10. 1. Department of Psychiatry, National Disaster Medical Center, Tokyo, Japan; Department of Psychiatry, Saitama Medical Center, Saitama Medical University, Saitama, Japan. 2. School of Distance Learning, Musashino University, Tokyo, Japan. 3. Department of Public Health, Faculty of Medicine, University of Toyama, Toyama, Japan. 4. Department of Cardiology, National Disaster Medical Center, Tokyo, Japan. 5. National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan. 6. Department of Psychiatry, National Disaster Medical Center, Tokyo, Japan. 7. Mental Health and Disability Health Division, Department of Health and Welfare for Persons with Disabilities, Ministry of Health, Labor and Welfare, Tokyo, Japan. 8. National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan. 9. Department of Psychiatry, Saitama Medical Center, Saitama Medical University, Saitama, Japan. 10. Department of Psychiatry, National Disaster Medical Center, Tokyo, Japan; Division of Health Care Research, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan. Electronic address: yumatsuo@ncc.go.jp.
Abstract
BACKGROUND: Around 20% of patients with acute coronary syndrome (ACS) develop depression. Furthermore, some observational studies revealed baseline polyunsaturated fatty acids (PUFAs) may affect the prognosis of depression after ACS. This prospective cohort study examined the association between psychiatric disorder and PUFAs after ACS. METHODS: Subjects were ACS patients admitted to a Tokyo teaching hospital. Psychiatric morbidity as a primary endpoint was measured using structured interview 3 months after admission. At admission, serum n-3 and n-6 PUFAs were measured by gas chromatography and patients were interviewed to evaluate medical information. Multiple logistic regression analysis was performed to calculate odds ratios (ORs) and 95% confidence intervals to examine the association between PUFAs at baseline and psychiatric disorder after ACS. RESULTS: Between March 2014 and August 2016, 100 patients completed the follow-up assessment. Eleven patients (11%) showed some form of new-onset psychiatric disorder at 3 months, mainly depressive episode (major, 5; minor, 1) and PTSD (full, 1; partial, 2). Psychiatric disorder was predicted by serum linoleic acid level (OR=3.96) and Hospital Anxiety and Depression Scale total score (OR=1.34) at baseline. No significant associations were seen with other PUFAs. LIMITATIONS: The results were obtained from a single hospital and based on a small number of participants. There might be some patients with new-onset psychiatric disorder among the refused patients. CONCLUSIONS: Psychiatric disorder incidence in ACS patients might be lower in Japan than in Western countries. Reduced intake of linoleic acid-containing foods might prevent depression or PTSD after ACS.
BACKGROUND: Around 20% of patients with acute coronary syndrome (ACS) develop depression. Furthermore, some observational studies revealed baseline polyunsaturated fatty acids (PUFAs) may affect the prognosis of depression after ACS. This prospective cohort study examined the association between psychiatric disorder and PUFAs after ACS. METHODS: Subjects were ACS patients admitted to a Tokyo teaching hospital. Psychiatric morbidity as a primary endpoint was measured using structured interview 3 months after admission. At admission, serum n-3 and n-6 PUFAs were measured by gas chromatography and patients were interviewed to evaluate medical information. Multiple logistic regression analysis was performed to calculate odds ratios (ORs) and 95% confidence intervals to examine the association between PUFAs at baseline and psychiatric disorder after ACS. RESULTS: Between March 2014 and August 2016, 100 patients completed the follow-up assessment. Eleven patients (11%) showed some form of new-onset psychiatric disorder at 3 months, mainly depressive episode (major, 5; minor, 1) and PTSD (full, 1; partial, 2). Psychiatric disorder was predicted by serum linoleic acid level (OR=3.96) and Hospital Anxiety and Depression Scale total score (OR=1.34) at baseline. No significant associations were seen with other PUFAs. LIMITATIONS: The results were obtained from a single hospital and based on a small number of participants. There might be some patients with new-onset psychiatric disorder among the refused patients. CONCLUSIONS:Psychiatric disorder incidence in ACS patients might be lower in Japan than in Western countries. Reduced intake of linoleic acid-containing foods might prevent depression or PTSD after ACS.