The role of daily adjustment disorder, depression and anxiety symptoms for the physical activity of cardiac patients

Background Physical activity (PA) is crucial in the treatment of cardiac disease. There is a high prevalence of stress-response and affective disorders among cardiac patients, which might be negatively associated with their PA. This study aimed at investigating daily differential associations of International Classification of Diseases (ICD)-11 adjustment disorder, depression and anxiety symptoms with PA and sedentary behaviour (SB) during and right after inpatient cardiac rehabilitation. Methods The sample included N = 129 inpatients in cardiac rehabilitation, M-age = 62.2, s.d.(age) = 11.3, 84.5% male, n = 2845 days. Adjustment disorder, depression and anxiety symptoms were measured daily during the last 7 days of rehabilitation and for 3 weeks after discharge. Moderate-to-vigorous PA (MVPA), light PA (LPA) and SB were measured with an accelerometer. Bayesian lagged multilevel regressions including all three symptoms to obtain their unique effects were conducted. Results On days with higher adjustment disorder symptoms than usual, patients engaged in less MVPA, and more SB. Patients with overall higher depression symptoms engaged in less MVPA, less LPA and more SB. On days with higher depression symptoms than usual, there was less MVPA and LPA, and more SB. Patients with higher anxiety symptoms engaged in more LPA and less SB. Conclusions Results highlight the necessity to screen for and treat adjustment disorder and depression symptoms during cardiac rehabilitation.

Automated summary

This study aimed to investigate the associations between adjustment disorder, depression, and anxiety symptoms with physical activity and sedentary behavior in inpatient cardiac rehabilitation. The results showed that adjustment disorder and depression symptoms were negatively associated with physical activity, while anxiety symptoms were positively associated with light physical activity. Therefore, it is important to screen for and treat these psychological symptoms during cardiac rehabilitation.