Associations between depression, resilience, and fatigue in patients with multivessel coronary disease: A cross-lag study

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This study aimed to examine the associations between depression, resilience, and fatigue in patients with multivessel coronary disease and verify their causal relationships. Between October 2023 and June 2024, 316 patients with multivessel coronary disease were recruited from three tertiary hospitals in Tangshan, China. The Patient Health Questionnaire, Connor-Davidson Resilience Scale, and the Multidimensional Fatigue Inventory were administered to the patients on the third day of admission (T1), one month after discharge (T2), and three months after discharge (T3). Pearson correlation analysis was conducted to examine the relationships among depression, resilience, and fatigue in patients with multivessel coronary disease, and cross-lagged analysis to explore the temporal causal relationships. In patients with multivessel coronary disease, levels of depression and fatigue decreased from T1 to T3, while resilience scores increased during the same period. The correlation analysis revealed significant relationships among depression, resilience, and fatigue at T1, T2, and T3 ( P < 0.01). The autoregressive paths indicated high stability over time for depression, medium stability for resilience, and low stability for fatigue. Cross-lagged paths demonstrated that depression at T1 significantly predicted fatigue at T2 ( β = 0.461, P < 0.001), and depression at T2 significantly predicted fatigue at T3 ( β = 0.957, P < 0.001). And resilience at T1 significantly predicted fatigue at T2 ( β = −0.271, P < 0.001), and resilience at T2 significantly predicted fatigue at T3 ( β = −0.176, P < 0.001). Additionally, resilience had a moderating effect on the relationship between depression and fatigue ( β = −0.760, P < 0.001). Our study confirmed that depression and resilience predicted fatigue in patients with multivessel coronary disease. To prevent and mitigate fatigue, alleviating depressive symptoms and enhancing resilience levels in patients at an early stage is essential.

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