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KMID : 1118520230200080707
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Psychiatry Investigation
2023 Volume.20 No. 8 p.707 ~ p.713
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Effect Modification of Cortisol on the Associations Between Obsessive-Compulsive Symptoms on Suicidality in Patients With Acute Coronary Syndrome
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Park Jin-Young
Kim Ju-Wan
Kang Hee-Ju
Choi Won-Suk
Lee Ju-Yeon
Kim Sung-Wan
Shin Il-Seon
Mohammad Rabiul Islam
Jeong Myung-Ho
Kim Jae-Min
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Abstract
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Objective : Obsessive-compulsive symptoms (OCS) and suicidal ideation (SI) are common in patients with acute coronary syndrome (ACS). This study investigated the associations of OCS and serum cortisol levels with SI, and further evaluated the possible modifying effects of cortisol on the associations between OCS and SI in acute and chronic phases of ACS.
Methods : In total, 969 ACS patients were recruited from a tertiary university hospital in Korea within 2 weeks of disease onset and evaluated in terms of OCS (using the OCS dimension of the Symptom Checklist-90-Revised), serum cortisol levels, and SI (using the “suicidal thoughts” item of the Montgomery-Asberg Depression Rating Scale). Covariates included sociodemographics, depression, vascular risk factors, and disease severity. After 1 year, 711 patients were re-evaluated in terms of SI. Logistic regression analysis was performed with adjustment for covariates.
Results : Higher OCS was significantly associated with SI both at baseline and follow-up. Serum cortisol showed no such association, but modified the association between OCS and SI. That was the associations were significant only in the higher but not in the lower serum cortisol levels, with significant interaction terms after adjusted for relevant covariates.
Conclusion : Evaluating OCS and serum cortisol levels at the acute phase could improve the accuracy of clinical predictions of SI both in the acute and chronic phases of ACS.
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KEYWORD
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Acute coronary syndrome, Serotonin, Cortisol, Obsessive-compulsive symptoms, Suicidality
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