Functioning in an Illness and Quality of Life versus the Prevalence of Depression and Anxiety Disorders in Patients with High Cardiovascular Risk

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Introduction:
is very short and general

methodology:
a group of patients with a very wide age range (18-80 years) was included in the study, which may affect the results obtained. It would be useful to indicate the breakdown by age group, as older patients may be at a higher risk for drug and depressive symptoms and lower HRQOL for reasons such as financial or lack of social support

Results:
I propose that table number 1 be placed in the “results” section
I think it will be interesting for the reader to indicate what comorbidities, in addition to those on the basis of which patients were included in the study, the patients studied had. Comorbidities and other clinical variables not shown in the results may affect the sense of subjective quality of life, but also determine the burden of anxiety and depression symptoms

Author Response

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Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

Dear Editor, 

 

First of all, thank you for giving me the opportunity to review this manuscript. The article cannot be accepted at this time. In the introduction section, more information is needed to better understand the rationale of this study. It is also not clear what the novel contribution of this study is.

 

The methodological approach is not clear: i) the study design is not well indicated; ii) more information is needed about the patient enrolment process (where? who collected the data? ...); iii) the instruments used are validated in Polish? iv) the statistical considerations need to be better explained; v) an explanation of the sample size is needed.

 

The description of the sample needs to be included at the beginning of the results section. The strength of the results is unclear due to the weaknesses of the methods.

Comments on the Quality of English Language

Moderate editing of English language required

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 3 Report

Comments and Suggestions for Authors

This is a clearly written, nicely presented report of a study examining the relationship between functioning, quality of life, and anxiety and depression in patients at high cardiovascular risk managed in primary care. The study design, methods and reporting appear appropriate and sound, with the findings being unsurprising, with the exception of the very low rates of clinical depression (3%) and anxiety (6.5%). However, the authors acknowledge this and discuss why there may be good reasons for this to be the case

My only minor criticism is the title, which could be more focused and shorter e.g. Anxiety and depression, quality of life and functioning in patients at high cardiovascular risk' 

Author Response

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Author Response File: Author Response.pdf

Round 2

Reviewer 2 Report

Comments and Suggestions for Authors

The manuscript cannot be accepted due to some methodological concerns:

-) A formal definition of sample size is needed in this study, where the authors would like to understand the relationship between functioning in chronic illness and quality of life. The authors indicated that "due to the study design, the size of the study population was arbitrarily defined...".

-) The enrollment procedure is unclear (probability sampling?). Also, the sample included is very non-homogeneous with respect to the time when risk factors were diagnosed (“… within 6 - 24 months prior to enrollment were diagnosed whit …”). The authors didn't collect information on the level of hypertension or hypercholesterolaemia and no information is available on medication control.

-) It is necessary to better understand the rationale of this study and its objective. 

-) The outcome needs to be better described. I suggest to describe the outcomes before and after the instrument used to collect these data.  

Comments on the Quality of English Language

Moderate editing of English language required.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf