Depression and Anxiety in a Cardiovascular Outpatient Clinic: A Descriptive Study

By Bayani, Baktash; Yousefi, Shakila et al. | Iranian Journal of Psychiatry, Summer 2011 | Go to article overview
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Depression and Anxiety in a Cardiovascular Outpatient Clinic: A Descriptive Study

Bayani, Baktash, Yousefi, Shakila, Bayani, Mahtab, Shirmohammadi, Maryam, Alimoradi, Abdollatif, Falsoleiman, Homa, Yazdi, Narges, Arbabi, Mohammad, Iranian Journal of Psychiatry

Objective: Cardiac diseases are psycho-somatic disorders, and psychological aspects play an essential role in their initiation and exacerbation. The aim of this study was to gain appropriate knowledge in the epidemiology of co-morbid depression and anxiety disorder in cardiovascular outpatients.

Method: This study is descriptive with a sample of patients attending a cardio-vascular clinic. 238 individuals were included in this study using a consecutive sampling method. The study instrument was Hospital Anxiety and Depression Scale (HADS) questionnaire, which is a clinical scale for assessing anxiety and depression.

Results: Of the 238 participants in this study, 93(38.7%) were male and 146 (61.3%) female. 28.5% of patients suffered from anxiety disorders , and 41.9% had depression. Regarding comorbid diseases such as diabetes mellitus, hyperlipidemia and hypertension, the severity of depression was just related to hypertension. There was a meaningful relationship between gender and symptoms of anxiety so that symptoms were more severe in women.

Conclusion: Considering the high prevalence of depression and anxiety in patients suffering from cardio-vascular diseases, it is necessary to screen psychological disorders in patients with cardio-vascular diseases and improve their cardio-vascular health and quality of life as mush as possible.

Keywords: cardiovascular diseases, depression, anxiety, HADS

Iran J Psychiatry 2011; 6:125-127

During recent years many studies have been conducted on cardiovascular diseases. Considering the chronic manner of such diseases, their mortality rate, and the burden of these diseases on the economic generative years of people on the one hand and the nature of this condition as the most preventable non contagious diseases on the other hand, special and increasing attention has been paid to cardiovascular diseases (1, 2).Considering the world burden of these disease until 2020, they are the main cause of the increase in mortality rate in underdeveloped countries. It has been predicted that in 2020, cardio -vascular diseases will result in 25 million deaths; and regarding current circumstances, it seems that these diseases will bring about 35 to 60 percent deaths worldwide (3).

In Iran, cardio-vascular diseases are a health problem with social consequences (4). It has been estimated that, with their current pace, cardio-vascular diseases will be the first cause of disability in the next decades. As the Age of the onset of vascular diseases has decreased, about 1.3% of deaths that occur after the age of 35 are the result of cardiovascular related diseases (4).

Considering the fact that cardiac diseases are categorized as Psycho-somatic disorders, psychological aspects play an essential role in their initiation and exacerbation directly or indirectly (5).Also, psychiatric disorders can be a common complication in those with cardiovascular disease.

Some studies demonstrated that there was a range of 5%-10% of anxiety and 15-20% of depressive disorders among patients at outpatient cardiac wards. Acute psychological stressors and personality characters have proved to be risk factors for cardio-vascular diseases, and recent studies imply that depression and anxiety are independent factors that affect mortality and morbidity in patients with cardiac diseases. (6)

From the biological point of view, depression can disturb regulation of autonomous nervous system and lessen the power of regulatory of the Vagus nerve in heart, which will result in an increase in the rate of acute heart failure. Also, there is a role for platelets in coagulation and clot making in coronary accident in depressed patients (7). Depression can lead to such unhealthy behaviors as smoking, unhealthy diet, alcoholism, lack of exercise and physical activity, which could give rise to cardio-vascular diseases .It has been estimated that cardiac symptoms in 10 to 20 percent of patients who refer to cardiologists are the consequences of psychiatric problems, most of which are related to anxiety, panic disorder and depression (8).

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