Anxiety and Depressive Symptoms among Ischaemic Heart Disease Patients in a Malaysian Tertiary University Hospital

Authors

  • Suzaily Wahab PPUKM

Keywords:

Anxiety - depression - ischaemic heart disease - acute coronary syndrome -heart disease.

Abstract

Introduction

Anxiety and depression were known to bring detrimental outcome in patients with ischemic heart disease (IHD). Notwithstanding their high prevalence and catastrophic impact, anxiety and depression were unrecognized and untreated. The aim of this study was to determine the prevalence of anxiety and depression among IHD patients and the association of this condition with clinical and selected demographic factors.


Methods

This was a cross-sectional study on 100 IHD patients admitted to medical ward in UKMMC. Patients diagnosed to have IHD were randomly assessed using Hospital Anxiety and Depression Scale (HADS) and Perceived Social Support (PSS) Questionnaire. Socio-demographic data were obtained by direct interview. Fifteen percent of IHD patients in this sample were noted to have anxiety, fourteen percent noted to have depression while thirty two percent was noted to have both anxiety and depression. Patients’ age group and the duration of illness were found to have significant association with anxiety. Socio-demographic data were obtained by direct interview.


Results

Fifteen percent of IHD patients in this sample were noted to have anxiety, fourteen percent noted to have depression while thirty two percent was noted to have both anxiety and depression. Patients’ age group and the duration of illness were found to have significant association wit¬h anxiety. The other clinical and selected demographic factors such as gender, race, marital status, education level, occupation, co-existing medical illness and social support were not found to be significantly associated with anxiety or depression among the IHD patients.


Conclusions

In conclusion, proper assessment of anxiety and depression in IHD patients, with special attention to patients’ age and duration of illness should be carried out routinely to help avert detrimental consequences.

Author Biography

Suzaily Wahab, PPUKM

Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre, 56000 Cheras, Kuala Lumpur, Malaysia.

References

Global status report on noncommunicable disaeses 2010 Geneva. World Health Organization. 2011.

Statistics on Causes of Death Malaysia Department Of Statistics, Malaysia. 2008.

Dekker RL, Lennie TA, Albert NM, Rayens MK, Chung ML, Wu JR, et al. Depressive symptom trajectory predicts 1-year health-related quality of life in patients with heart failure. Journal of cardiac failure. 2011;17(9):755-63.

Müller-Tasch T, Peters-Klimm F, Schellberg D, Holzapfel N, Barth A, Jünger J, et al. Depression is a major determinant of quality of life in patients with chronic systolic heart failure in general practice. Journal of cardiac failure. 2007;13(10):818-24.

Fan AZ, Strine TW, Jiles R, Mokdad AH. Depression and anxiety associated with cardiovascular disease among persons aged 45 years and older in 38 states of the United States, 2006. Preventive medicine. 2008;46(5):445-50.

Nicholson A, Kuper H, Hemingway H. Depression as an aetiologic and prognostic factor in coronary heart disease: a metaanalysis of 6362 events among 146 538 participants in 54 observational studies. European Heart Journal 2006;27:2763-74.

Axon RN, Zhao Y, Egede LE. Association of depressive symptoms with all-cause and ischemic heart disease mortality in adults with self-reported hypertension. American Journal of Hypertension. 2010;23(1):30-7.

Kubzansky LD, Cole SR, Kawachi I, Vokonas P, Sparrow D. Shared and unique contributions of anger, anxiety, and depression to coronary heart disease: a prospective study in the normative aging study. Annals of Behavioral Medicine,. 2006; 31(1):21-9.

Lichtman JH, Bigger JT, Blumenthal JA, Frasure-Smith N, Kaufmann PG, Lespérance F, et al. Depression and coronary heart disease recommendations for screening, referral, and treatment: a science advisory from the American Heart Association Prevention Committee of the Council on Cardiovascular Nursing, Council on Clinical Cardiology, Council on Epidemiology and Prevention, and Interdisciplinary Council on Quality of Care and Outcomes Research: endorsed by the American Psychiatric Association. Circulation. 2008;118(17):1768-75.

De Jonge P, Mangano D, M.A W. Differential association of cognitive and somatic symptoms with heart rate variability in patients with stable coronary heart disease findings from the Heart and Soul study. Psychosom Med. 2007;69:735-9.

Brouwers C, Mommersteeg P, NyklíÄek I, Pelle AJ, Westerhuis BL, Szabó BM, et al. Positive affect dimensions and their association with inflammatory biomarkers in patients with chronic heart failure. Biological psychology. 2013; 92(2):220-6.

Parissis JT, Fountoulaki K, Filippatos G, Adamopoulos S, Paraskevaidis I, Kremastinos D. Depression in coronary artery disease: novel pathophysiologic mechanisms and therapeutic implications. International journal of cardiology. 2007; 116(2):153-60.

Otte C, Neylan TC, Pipkin SS, Browner WS, Whooley MA. Depressive symptoms and 24-hour urinary norepinephrine excretion levels in patients with coronary disease: findings from the Heart and Soul Study. American Journal of Psychiatry. 2005;162(11):2139-45.

Von Känel R, Begré S, Abbas CC, Saner H, Gander ML, Schmid JP. Inflammatory biomarkers in patients with posttraumatic stress disorder caused by myocardial infarction and the role of depressive symptoms. Neuroimmunomodulation. 2009;17(1):39-46.

Iny LJ, Pecknold J, Suranyi-Cadotte BE, Bernier B, Luthe L, Nair NP, et al. Studies of a neurochemical link between depression, anxiety, and stress from [3H] imipramine and [3H] paroxetine binding on human platelets. Biological psychiatry. 1994;36(5):281-91.

Kirmayer LJ. Cultural variations in the clinical presentation of depression and anxiety: implications for diagnosis and treatment. Journal of Clinical Psychiatry. 2001;62:22-30.

Lin KM. Biological differences in depression and anxiety across races and ethnic groups. The Journal of clinical psychiatry. 2000;62:13-9.

Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica. 1983; 67 (6):361-70.

Procidano ME, Heller K. Measures of perceived social support from friends and from family: Three validation studies. American journal of community psychology. 1983;11(1):1-24.

Rudisch B, Nemeroff CB. Epidemiology of comorbid coronary artery disease and depression. Biological psychiatry. 2003;54(3):227-40.

Van Melle JP, De Jonge P, Spijkerman TA, Tijssen JG, Ormel J, Van Veldhuisen DJ, et al. Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: a meta-analysis. Psychosomatic Medicine. 2004;66(6):814-22.

Bjerkeset O, Nordahl HM, Mykletun A, Holmen J, Dahl AA. Anxiety and depression following myocardial infarction: gender differences in a 5-year prospective study. Journal of psychosomatic research. 2005;58(2):153-61.

Dogar IA, Khawaja IS, Azeem MW, Awan H, Ayub A, Iqbal J, et al. Prevalence and risk factors for depression and anxiety in hospitalized cardiac patients in Pakistan. Psychiatry (Edgmont). 2008;5(2):38.

Luttik MLA, Jaarsma T, Sanderman R, Fleer J. The advisory brought to practice Routine screening on depression (and anxiety) in coronary heart disease; consequences and implications. European Journal of Cardiovascular Nursing. 2011;10(4):228-33.

Bjelland I, Krokstad S, Mykletun A, Dahl AA. The HUNT study:Does a higher educational level protect against anxiety and depression?. Social Science and Medicine. 2008;66:1334-45.

Hinz A, Kittel J, Karoff M, Schwarz R. Age and sex dependencies of anxiety and depression in cardiologic patients compared with the general population. GMS Psycho-Social-Medicine. 2004.

Arora D, Anand M, Katyal VK, Anand V. Anxiety and Well-being among Acute Coronary Syndrome Patients: Overtime. J Indian Acad Appl Psych. 2010;36(1):79-88.

Kuper H, Marmot M, Hemingway H. Systematic review of prospective cohort studies of psychosocial factors in the aetiology and prognosis of coronary heart disease. Coronary heart disease epidemiology. 2005:363-413.

Alloway R, Bebbington P. The buffer theory of social support: A review of the literature. Psychological medicine. 1987;17(1):91-108.

Goldston K, Baillie AJ. Depression and coronary heart disease: a review of the epidemiological evidence, explanatory mechanisms and management approaches. Clinical psychology review.28(2):288-306.

Holahan CJ, Moos RH, Holahan CK, Brennan PL. Social support, coping, and depressive symptoms in a late-middle-aged sample of patients reporting cardiac illness. Health Psychology. 1995;14:152–63.

Frasure-Smith N, Lespérance F, Gravel G, Masson A, Juneau M, Talajic M, et al. Social support, depression, and mortality during the first year after myocardial infarction. Circulation. 2000;101(16):1919-24.

Muran EM, Motta RW. Cognitive distortions and irrational beliefs in postâ€traumatic stress, anxiety, and depressive disorders. Journal of Clinical Psychology.49(2):166-76.

Beck AT. Thinking and depression: I. Idiosyncratic content and cognitive distortions. Archives of General Psychiatry. 1963;9(4):324-33.

Beck AT, Emery G, Greenberg RL. Anxiety disorders and phobias: A cognitive perspective: Basic Books; 2005.

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Published

2015-03-01

How to Cite

Wahab, S. (2015). Anxiety and Depressive Symptoms among Ischaemic Heart Disease Patients in a Malaysian Tertiary University Hospital. International Journal of Public Health Research, 5(1), 531–537. Retrieved from https://spaj.ukm.my/ijphr/index.php/ijphr/article/view/163