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Features of Coronary Heart Disease Course in Patients with Depressive Disorders

Published online by Cambridge University Press:  23 March 2020

N. Garganeeva
Affiliation:
Federal State Budgetary Educational Institution of High Education “Siberian State Medical University” of Ministry of Healthcare of Russian Federation, General Medical Practice and Polyclinic Therapy Department, Tomsk, Russia
M. Belokrylova
Affiliation:
Mental Health Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Borderline States Department, Tomsk, Russia Federal State Budgetary Educational Institution of High Education “Siberian State Medical University” of Ministry of Healthcare of Russian Federation, Psychiatry, Addiction Psychiatry and Psychiatry Department, Tomsk, Russia

Abstract

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Multifactor risk for coronary heart disease (CHD) development is associated with susceptibility and depressive reaction to stressful situations that causes search for ways of optimization of integrative assistance to CHD patients with depressive disorders.

Objective

To carry out comparative analysis of dynamics of mental and physical state in CHD pateints.

Material and methods

Two hundred and eighty (57.74 ± 5.59 years) CHD patients with grade II–III angina pectoris were examined. Psychopathological method, Center of Epidemiological Studies-Depression scale (CES-D) were used.

Results

Ninety patients (32.1%) had depressive disorders within depressive episode, dysthymia, adjustment disorder. The level of depression according to CES-D varied from 19 to 28 points. Comparative analysis of two groups of patients showed that CHD patients with depression had more severe grade III angina (22.1% vs. 11.6%; P = 0.036) more frequently. Differences regarding frequency of arterial hypertension (AH) (91.1% vs. 63.2%; P = 0.0002), type 2 diabetes mellitus (DM) (26.8% vs. 17.5%; P = 0.038), obesity (30.7 ± 3.9 vs. 29.5 ± 4.5; P = 0.015), arrhythmias (34.4% vs. 25.2%; P = 0.015); cases of myocardial infarction (47.8% vs. 17.9%; P = 0.0001) were revealed. Among patients with depressive disorders persons with experience of surgical myocardial revascularization (P = 0.004), degree II–III of disability (23.3% vs. 11.6%; P = 0.0118) were present more frequently. Patients with depression were characterized by low economic status (64.4% vs. 23.7%; P = 0.0001); absence of social support (34.4% vs. 12.6%; P = 0.0001); frequent stress situations in personal history (71.1% vs. 32.6%; P = 0.0002).

Conclusions

Depressive disorders caused by psychosocial stress influence negatively CHD course that requires complex approach to therapy of comorbid pathology.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
e-poster walk: Consultation liaison psychiatry and psychosomatics–Part 1
Copyright
Copyright © European Psychiatric Association 2017
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