Depression and anxiety following myocardial infarction and their inverse associations with future health behaviors and quality of life

Background: Post-myocardial infarction (MI) depression and anxiety were found to predict prognosis and quality of life. Purpose: The purpose of this study was to test a behavioral pathway from post-MI depression/anxiety to future quality of life. Methods: This is a longitudinal cohort study. Five hundred forty patients (≤65 years old) filled out questionnaires after a first MI, including socio-demographics, pre-MI health status and behaviors, MI severity, social support, sense of coherence, depression, and anxiety. Reports of health behaviors were obtained 5 years and of quality of life 10 years later. Results: A structural equations model confirmed that depression and anxiety were directly related to poorer quality of life 10 years later. These relationships were partly mediated by a positive association between anxiety and health behaviors at 5 years and a negative one between depression and health behaviors. Conclusions: The opposite effects of anxiety and depression underscore the need to attend to both emotional reactions to MI while encouraging preventive health behaviors.