The impact of fear of recurrence and progression on mental health after spontaneous coronary artery dissection: the role of illness uncertainty.

The study measured fear, uncertainty, and mental health at one time, so it cannot show that fear or uncertainty causes later depression or distress. 40 participants were excluded because the required measures were late in the survey, which may bias the results. The sample was mostly partnered, employed, university-educated, Australian-born women, and only 13% had SCAD in the past year, so it may not represent all survivors. The fear scale was not validated in cardiac patients, and one item may have measured general anxiety; removing it changed the anxiety result. The analysis did not include covariates such as age, sex, pre-existing mental health conditions, or time since SCAD. Illness uncertainty was measured with a general community scale, not a SCAD-specific measure.

The supplied text lists funders: Sarah Ford and SCAD Research Inc, Australian Government Research Training Program Scholarship, National Heart Foundation of Australia, NSW Health Cardiovascular Senior Scientist, US National Institutes of Health, Leducq Foundation, Snow Medical, Bourne Foundation, Angles Family Foundation, SCAD Research Inc, and Agilent. It does not state author conflicts.

Do not conclude that reducing uncertainty will improve mental health or that fear causes depression. The study measured people at one time, and the anxiety result was not clear in the main analysis; it became clearer only after a later check changed the fear scale.