Predicting Depression from Illness Severity in Cardiovascular Disease Patients: Self-efficacy Beliefs, Illness Perception, and Perceived Social Support as Mediators

Background: Many studies have investigated the relationships between cardiovascular diseases and patients' depression; nevertheless, few is still known as regard the impact of illness severity on depression and whether psychosocial variables mediate this association. Purpose: The aim of this study is to investigate the putative mediating role of illness representations, self-efficacy beliefs, and perceived social support on the relationship between illness severity and depression. Methods: A total of 75 consecutive patients with cardiovascular disease (80 % men; mean age=65.44, SD=10.20) were enrolled in an Italian hospital. Illness severity was measured in terms of left ventricular ejection fraction, whereas psychological factors were assessed using self-report questionnaires. Results: The relationship between left ventricular ejection fraction and depression was mediated by identity illness perception, self-efficacy beliefs in managing cardiac risk factors, and perceived social support. Conclusion: The treatment of depression in cardiovascular disease patients may therefore benefit from a psychological intervention focused on patients' illness representations, self-efficacy beliefs, and their perceived social support. © 2013 International Society of Behavioral Medicine.