Depression and perceived behavioral control are independent predictors of future activity and fitness after coronary syndrome events

Objective: Physical inactivity increases the risk of recurrent coronary events, and both depression and perceived behavioral control (PBC) have been shown to influence levels of physical activity. However, it is not known whether depression and PBC affect activity levels independently of one another. The present study investigates whether depression and PBC exert independent effects on future exercise and fitness in patients hospitalized for coronary syndrome events. Methods: Five hundred and two patients (hospitalized for myocardial infarction or newly diagnosed angina) reported their levels of depression, PBC, and current regular exercise prior to discharge from hospital, and leisure activities, fitness, regular exercise, and depression 12 months later. The ability of depression and PBC to predict patient's reported levels of activity (n=388) and fitness (n=361) was determined with regression analyses. Results: Depression prior to discharge from hospital reliably predicted fitness (P <.005), self-reported leisure activities (P <.005), and taking regular exercise (P <.005) 12 months after hospitalization for coronary syndrome events when controlling for age, gender, socio-economic status, illness severity, and reported activity prior to hospitalization. Depression at 12 months explained the variance in all outcome measures previously explained by depression at discharge, but PBC during hospitalization independently predicted leisure activities (P<.005) and taking regular exercise (P <.005) 12 months later. Conclusions: Perceived behavioral control and depression independently predict activity and fitness in patients 12 months after hospitalization for coronary syndrome events. Consequently, interventions aiming to increase activity and fitness in these patients should take account of both patients' perceptions of control and their level of depression. (c) 2007 Elsevier Inc. All rights reserved.