Psychosocial factors, anxiety and depressive disorders in patients with coronary artery disease: Problems of comorbidity and prognosis

Abstract

Aim. To assess the significance of psychosocial factors, anxiety and depressive disorders in predicting the comorbidities in patients with coronary artery disease (CAD). Material and methods. The study included 132 patients aged 37 to 66 years with CAD and anxiety-depressive disorders. Depression was found in 42% of patients, anxiety — in 25%; combination of anxiety, depression — in 33%. The assessment of the significance of cardiovascular and psychosocial factors in predicting comorbidities in patients with CAD was carried out using the logistic regression. Results. The total prognosis percentage was 95,4% in the general group of patients (Somers’D — 0,910). In the group of men, it was 95,5% (Somers’D –0,912); in the group of women — 93,1% (Somers’D — 0,877). The predictors with a high significance level (p=0,0001) were following cardiovascular risk factors: patient age, hypertension, diabetes, dyslipidemia, left ventricular hypertrophy, arrhythmias, smoking, positive family history of cardiovascular diseases and others. Following psychosocial factors were also significant: stress and characteristics of stressors, active psychopathological syndrome with leading anxiety and/or depressive symptoms, the patient age at the onset of mental disorder diagnosis, duration of the mental disorder, and psychological characteristics of patients. The age of the mental disorder onset was found to be related to the previous stressful events (p=0,0001). A relationship was found between the age of patients with the onset of mental disorder and the severity of CAD (p=0,0001), as well as with the age of CAD onset and the sex of patients (p=0,0007). The contribution of stressful events before anxiety and depressive disorders to the development of predictors effecting the course and diagnosis of CAD was shown. Conclusion. Logistic regression showed a relevant relationship of cardiovascular risk factors, psychosocial factors, anxiety and depressive disorders, included in the list of significant predictors of comorbidities and the progression of CAD. The results obtained serve as a guideline for an interdisciplinary approach to the treatment and prevention of comorbidities.