The nature of the depressive symptomatology preceding myocardial infarction

Little is known about the nature of the depressive symptomatology preceding myocardial infarction (MI). Specification of the depressive symptomatology is important for the development of hypotheses about the biological mechan isms relating depressive symptoms to MI. To test the hypothesis that feelin gs of fatigue and loss of energy have the strongest predictive power of all depressive symptoms, the authors reanalyzed data from a prospective study of 3877 healthy men aged 40 to 65 years. The men's mental state was assesse d using the Maastricht questionnaire, a scale that measures viral exhaustio n, which is characterized by unusual fatigue and lack of energy, increased irritability, and depressive symptoms, including demoralization. Oblique fa ctor analysis was used to validate these dimensions. Results of Cox's regre ssion analyses showed that the fatigue subscale has the strongest predictiv e power for incident MI and that depression and irritability subscales lose their predictive power when controlled for fatigue.