Socioeconomic status, social environment, depression and postdischarge adjustment of the cardiac patient

In this study, we assess the adjustment achieved by patients following disc harge from coronary care and the role of socioeconomic status (SES), social environment (SE), and depression in achieving that adjustment. Two hundred eighty-seven patients were enrolled. The SE into which the patients were t o be discharged was rated signficantly poorer for patients of lower SES, wh o also scored higher on depression. At 1, 6, and 12 months postdischarge, l ower SES patients recorded significantly poorer levels of adjustment across a range of functioning. Predischarge depression, together with measures of SE and SES, determined 10% to 28% of the variance in 12-month postdischarg e adjustment. These data suggest the importance of identifying patients at greater risk for less than optimal outcome (those lower in SES and higher i n depression), and the need to address the nature of the SE in which the pa tient has to effect his/her recovery. (C) 1998 Elsevier Science Inc.