Do recent life events and social support explain gender differences in depressive symptoms in patients who had percutaneous transluminal coronary angioplasty?

OBJECTIVE: Previous studies have documented that among patients with coronary artery disease (CAD), depressive symptoms are more common in women than in men. The objective of this study was to determine if this disparity was explained by gender differences in stressful life events and in perceived social support.

METHODS: This was a cross-sectional study involving patients who recently had percutaneous transluminal coronary angioplasty (PTCA). Logistic regression was used to test the associations among gender, depressive symptoms, stressful life events, and social support. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D).

RESULTS: Of the 660 patients enrolled, 27% were women. A higher proportion of women than men were classified as having substantial depressive symptoms based on a cutoff score of > or =16 on the CES-D (43% vs. 29%, p < 0.01). More women reported experiencing personal stressful life events than men (33% vs. 23%, p < 0.05). Fewer women than men reported having tangible support, which in this study was defined as having someone available to help with chores (68% vs. 85%, p < 0.001). On mediation analysis, the strength of the association between gender and depressive symptoms was diminished after personal stress and tangible social support variables were added to the logistic regression model.

CONCLUSIONS: In this population of postangioplasty patients, more women reported having depressive symptoms than men. This disparity may be partially explained by the finding that compared with men, more women experienced personal stressful life events and perceived less tangible support.