Moderators of the effect of social support on depressive symptoms in cardiac patients

Social support and depression have been shown to affect the prognosis of co ronary patients, and social support has been found to influence depression in community and patient samples. We investigated the characteristics of co ronary patients whose depressive symptomatology was most likely to improve with social support, We predicted that social support would be most benefic ial for the most severely depressed, the old, the poor, the most severely i ll, and those with poor functional status, Patients (n = 590) with document ed coronary artery disease were assessed for depressive symptoms, social su pport, and functional status while in hospital. They were reassessed for de pression 1 month later during a home visit. Depression scores were lower at follow-up (p = 0.001), and improvement was more marked among those reporti ng more support (p <0.001), The social support effect was strongest among t hose with high levels of depression at baseline (p <0.001) and those with l ower income (p = 0.01), Unexpectedly, social support was more strongly asso ciated with improvement in younger patients (p = 0.01). Social support did not interact with gender, disease severity, or functional status, These fin dings are partially consistent with the notion that social support is most effective for those who are most vulnerable and/or have few coping resource s, These findings also have implications for the design and interpretation of psychosocial interventions. (C)2000 by Excerpta Medico, Inc.