Psychological distress, use of rehabilitation services, and disability status among noninstitutionalized US adults aged 35 years and older, who have cardiovascular conditions, 2007

To investigate whether psychological distress is associated with disability status and use of rehabilitation services among adults aged 35 years and older with cardiovascular conditions. Using 2007 data from the Behavioral Risk Factor Surveillance System (BRFSS), we assessed the association between serious psychological distress (SPD) and the prevalence of disability and use of outpatient rehabilitation services among cardiovascular disease (CVD) survivors aged 35 years or older. Respondents' SPD status was ascertained by the Kessler 6 questionnaire; their CVD survivor status was based on self-reports of physician-diagnosed coronary heart disease (CHD) or stroke; and their disability status was based on self reports of activity limitation and use of special equipment. The prevalence of SPD was higher among respondents with a CVD history than those without. Among CVD survivors, those with SPD had worse disability status than those without SPD; the rate of having used any outpatient rehabilitation services following a heart attack or stroke was not significantly different by SPD status. Further studies are needed to confirm whether higher rate of disability among CVD survivors with SPD is attributable to conditions that can be corrected or improved by rehabilitation services; whether alleviating psychological distress among CVD survivors may lead to more frequent use of rehabilitation services and thus to a reduction in their rate of disability.