BACKGROUND Depression and anxiety symptoms (termed distress) are common among coronary heart disease (CHD) patients and associated with poor outcomes. Illness perceptions predict distinct outcome trajectories in other long-term conditions, yet it is not known how they relate to distress trajectories in CHD. PURPOSE This study aimed to examine whether baseline illness perceptions are associated with distress symptom trajectories among primary care CHD patients. METHODS This is a secondary analysis of 803 CHD patients from the UPBEAT-UK study, who completed the Hospital Anxiety and Depression Scale every 6 months for 3 years. Baseline assessments included the Brief Illness Perception Questionnaire. Using latent class growth analysis, Palacios et al. (2018) identified five distinct distress symptom trajectories ("stable low," "chronic high," "improving," "worsening," and "fluctuating") in this cohort. Adjusted multinomial logistic regression analyses were used to test the association between baseline illness perceptions and distress symptom trajectories. RESULTS Compared with the stable low distress trajectory, stronger illness identity (odds ratio [OR] = 1.31, p < .01), higher perceived consequences (OR = 1.47, p < .01), illness-related emotion (OR = 1.66, p < .01), and illness concerns (OR = 1.36, p < .01) increased the odds of having chronic high distress. Stronger illness coherence (OR = 0.89, p < .05) and personal (OR = 0.77, p < .01) and treatment control (OR = 0.75, p < .01) reduced the odds of chronic high distress. Worsening distress symptoms were associated with weaker perceptions of treatment control, higher perceived consequences, and greater illness-related concerns and emotions. CONCLUSIONS Illness perceptions of CHD are associated with distress symptom trajectories. Therapeutically modifying unhelpful illness perceptions in CHD patients who experience high levels of distress could potentially improve mental health outcomes.

中文翻译：

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患有冠心病的个体超过3年的独特窘迫症状轨迹与基线疾病知觉相关。

背景技术抑郁和焦虑症状（称为痛苦）在冠心病（CHD）患者中很常见，并且与不良预后相关。疾病知觉可以预测其他长期条件下不同的结局轨迹，但尚不知道它们与冠心病的窘迫轨迹有何关系。目的本研究旨在检查基本医疗CHD患者的基线疾病知觉是否与困扰症状轨迹有关。方法这是对UPBEAT-UK研究中的803名CHD患者的二次分析，他们每6个月完成一次为期3年的医院焦虑和抑郁量表。基线评估包括简短疾病知觉问卷。使用潜在类增长分析，Palacios等。（2018年）确定了五种不同的求救症状轨迹（“稳定低”，“ 更高的可感知后果，以及与疾病相关的更多担忧和情绪。结论冠心病的疾病知觉与痛苦症状轨迹有关。在患有高水平困扰的冠心病患者中，通过治疗性方法改变无助的疾病认识可能会改善心理健康状况。