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Investigation and Study of the Psychologic Status in Patients with Coronary Artery Disease

Author: CuiJianGuo
Tutor: LiChunJian
School: Nanjing Medical University
Course: Internal Medicine
Keywords: Coronary artery disease Anxiety Depression Psychological Intervention menopause influential factors Gensini score psychologic status
CLC: R541.4
Type: Master's thesis
Year: 2009
Downloads: 38
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Abstract


Objective To investigate the incidence rate and the severity of anxiety and depression in hospitalized patients with coronary artery disease(CAD). Methods Patients who satisfied the diagnostic criteria of coronary artery disease were recruited and divided into four subgroups, i.e. stable angina (SA) , unstable angina (UA) , non-ST elevation myocardial infarction (NSTEMI) and ST-segment elevation myocardial infarction (STEMI).The self-rating anxiety scale (SAS) and the self-rating depression scale (SDS) were employed to evaluate the psychologic status of the subjects.The cutoff values of SAS and SDS were set at 50 and 53 respectively.The severities of anxiety and depression were graded by 3 degrees as mild,moderate and severe.Student’s t test,one-way ANOVA , Chi-square test and rank sum test were adopted to analyze the results. Results The scores of SAS of the total subjects and the four subgroups were all significantly higher than that of the standardized SAS model (P<0.001,P<0.05).The incidence rate of anxiety in the total subjects was 23.4%,in which the mild grade was 19.4%,the moderate grade was 3.5%,and the severe grade was 0.4%.The score of SAS (P<0.05 for all) and the incidence rate of anxiety(P=0.020,0.0010 respectively)in UA group were significantly higher than those in SA group and STEMI group.The scores of SAS and the incidence rates of anxiety among other subgroups did not show significant difference.The severities of anxiety among the four subgroups did not show significant difference either.The scores of SDS of the total subjects (P<0.001) and the four subgroups(SA P<0.05;UA P<0.001;NSTEMI P<0.05;STEMI P<0.001) were significantly higher than that of the standardized SDS model(P<0.001, P<0.05). The incidence rate of depression in the total subjects was 25.9%,in which the mild grade was 20.0%,the moderate grade was 4.7%,and the severe grade was1.2%.There were no significant differences of the SDS scores,the incidence rates or the severities of depression among the four subgroups.The scores of SAS and SDS in female were both significantly higher than that of male(SAS P=0.003;SDS P=0.002).There were no significant differences of the incidence rates or the severities of anxiety between male and female, while both the incidence rate and the severity of depression in female were significantly higher than that in male(P<0.001;P=0.031).Conclusions About one fourth of the hospitalized CAD patients were complicated with different degrees of the anxiety and/or depression;UA patients were more likely to exhibit anxiety than other types of CAD patients.The incidence rate and the severity of depression in female were higher than that in male. including psychological intervention and health care education support on psychologic status of patients with coronary heart disease after discharge from hospital. Methods Patients who satisfied the diagnostic criteria of coronary artery disease were recruited.The self-rating anxiety scale (SAS) and the self-rating depression scale (SDS) were employed to evaluate the psychologic status of the subjects when they was on admission and discharge one year later.Results Total 509 patients were recruited at first,115 patients were return visited and 107 questionnaires were effective. The scores of SAS of the total subjects was significantly higher than that of the standardized SAS model (P<0.01).There was no significant difference between SDS scores of the total subjects and that of the standardized SAS model.The scores of SAS and SDS of the subjects which were done discharge one year later were significant higher than that of the subjects which were done on admission (SAS P < 0.01,SDS P < 0.05).The incidence rate and the severities of anxiety and depression in the subjects were done discharge one year later were significant higher than that of the subjects which were done on admission ( P < 0.05 for all) Conclusions Psychological Intervention and health care education support can reduce the incidence rate and the severities of anxiety and depression in the patients with CAD. menopause and anxiety,depression and coronary atherosclerosis. Methods The study population consisted of 82 consecutive postmenopause female patients who underwent coronary angiography and confirmed coronary atherosclerosis and without estrogen replacement therapy. The severity of coronary atherosclerosis was defined by the Gensini’s score system. The patients’psychological status were investigated, and the anthropometric measurements including stature,weight,waistline and hipline. Blood samples from every patient were drawn at admission to the coronary unit and the white cell count ,red cell count and blood platelets were measured. the plasma measurements including lipid,blood glucose ,urea,creatinine and uric acid were performed. 82 cases were allocated into two groups according to the age of menopause. Analysis of student’s T test was employed to investigate the distribution of the clinical data in groups. Spearman’s correlation analysis and multivariate stepwise linear regression analysis were employed to explore the relationship between the age of menopause and cardiovascular risk factors. Results When the age of menopause was examined as a categorical variable classified by middle age of menopause, subjects without body mass index showed no statistic significance. There was positively correlated between the age of menopause and body mass index,high-density lipoprotein cholesterol and hipline. Multiple stepwise linear regression analysis demonstrated that high-density lipoprotein cholesterol,hipline and fast blood glucose significantly independently associated with the age of menopause. Conclusion The age of menopause was associated significant with several factors. Hipline, high-density lipoprotein cholesterol and fast blood glucose was independently associated with the age of menopause.

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CLC: > Medicine, health > Internal Medicine > Heart, blood vessels ( circulatory ) disease > Heart disease > Coronary arteries ( atherosclerosis ),heart disease (CHD)
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