The scores of Hamilton depression, anxiety, and panic agoraphobia rating scales in patients with acute coronary syndrome

ACER, Mehmet; VURAl, Mutlu; AKBAŞ, NAZ BERFU

The scores of Hamilton depression, anxiety, and panic agoraphobia rating scales in patients with acute coronary syndrome

Mutlu VURAL, (Kırşehir Devlet Hastanesi, Kardiyoloji Bölümü, Kırşehir, Türkiye)

Mehmet ACER, (Kırşehir Devlet Hastanesi, Psikoloji Kliniği, Kırşehir, Türkiye)

NAZ BERFU AKBAŞ (Yeditepe Üniversitesi, Tıp Fakültesi, Psikiyatri Anabilim Dalı, İstanbul, Türkiye)

Anadolu Kardiyoloji Dergisi

8 3

Yıl: 2008 Cilt: 8 Sayı: 1 Sayfa Aralığı: 43 - 47 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

The scores of Hamilton depression, anxiety, and panic agoraphobia rating scales in patients with acute coronary syndrome

Öz:

Amaç: Psikolojik faktörler koroner arter hastalığı gelişimi ve prognozunu olumsuz etkilemektedir. Bu çalışmada akut koroner sendrom nedeni ile tedavi görmüş olan hastalarda depresyon, anksiyete ve panik agorafobi düzeylerini ölçmeyi amaçladık. Ayrıca; depresyon, anksiyete ve panik agorafobi skorlarının koroner risk faktörleri, bazı klinik değişkenler ve koroner kalp hastalığı ile ilişkisini araştırmayı amaçladık.Yöntemler: Bu kros-seksiyonel, gözlemsel çalışmada bir zaman diliminde Hamilton depresyon, anksiyete ve panik agorafobi değerlendirme ölçeği (HAM-D, HAM-A ve HAM-PA) kullanılarak hastaların sırasıyla depresyon, anksiyete ve panik agorafobi düzeyleri akut koroner sendrom nedeni ile tedavi görmüş olan 82 hastada değerlendirilmiştir. Bu psikolojik değişkenlerin cinsiyet, diyabet, hiperkolesterolemi ve revaskülarizasyon ile ilişkisi değerlendirilmiştir. İstatistiksel analiz bağımsız olmayan değişkenler için eşsiz t-test ve Ki-kare testi kullanılarak yapılmıştır. Bulgular: Hastaların geneli erkek olup (54 erkek, 28 kadın) yaş ortalaması 61.9±12.1 yıl idi. Toplamda %46 hastada kararsız anjina, %37.8 hastada ST yükselmeli miyokard infarktüsü ve %16.7 hastada ST yükselmesiz miyokard infarktüsü nedeni ile tedavi uygulanmıştır. Depresif semptomlar (HAM-D skoru>8) hastaların %87.8’inde rastlanmıştır. HAM-D HAM-A ve HAM-PA skorları ile yakın ilişki içerisindedir (p<0.001). HAM-D, HAM-A ve HAM-PA skorları kadın hastalarda anlamlı olarak yüksek bulunmuştur (p<0.001).Cinsiyet kontrol edildikten sonra diyabet bulunan hastalarda hem HAM-D skoru (15.10±7.30’a karşılık 21.05±7.72; p=0.02), hem de HAM-A skoru (12.96±7.77’e karşılık 19.17±9.5; p=0.03) anlamlı olarak yüksek saptanmıştır. Ortalama HAM-D skoru hiperkolesterolemi (13.97±6.38’e karşılık 18.10±8.23; p=0.02) ve serebrovasküler hastalık öyküsü olan hastalarda (15.89±7.45’e karşılık 23,2±9,62; p=0,02) anlamlı olarak yüksek saptanmıştır. Baypas ameliyatı olan hastalarda HAM-D skoru (16.6±8.1’e karşılık 12.5±7.8; p=0.03) ve HAM-A skoru (15.56±8.50’ye karşılık 9.6±6.3; p=0.01) daha düşük düzeydedir. Sonuç: Yüksek depresyon, anksiyete ve panik agorafobi düzeyleri özellikle kadınlarda olmak üzere diyabet, hiperkolesterolemi ve serebrovasküler hastalığı olan hastalarda sık rastlanan bir bulgudur. Depresyon ve anksiyete bozukluğu akut koroner sendrom tedavisi gören hastalarda yaygın olmalıdır. Bize göre akut koroner sendrom tedavisi sonrası hastaların psikolojik yönden yakından izlenmesi ve tedavisi önemlidir. Bu yaklaşımla akut koroner sendromun olası olumsuz sonuçları önlenebilir.

Anahtar Kelime: Panik bozukluğu Psikiyatrik durum derecelendirme ölçekleri Diabetes mellitus Hiperkolesterolemi Kaygı bozuklukları Depresif bozukluk Geriyedönük çalışma Agorafobi Miyokard enfarktüsü

Konular: Kalp ve Kalp Damar Sistemi

Akut koroner sendrom nedeni ile tedavi görmüş olan hastalarda Hamilton depresyon, anksiyete ve panik agorafobi düzeyleri

Öz:

Objective: Psychological factors may influence the development and prognosis of coronary heart disease. The purpose of this study was to measure levels of depression, anxiety, and panic agoraphobia in patients who had been treated for acute coronary syndrome (ACS). We attempted to evaluate the relationship of the scores of depression, anxiety and panic agoraphobia, coronary risk factors, some clinical variables and coronary heart disease. Methods: We evaluated the levels of depression, anxiety, and panic agoraphobia of patients who had been treated for ACS, using the Hamilton depression (HAM-D), the Hamilton anxiety (HAM-A), and the Hamilton panic agoraphobia (HAM-PA) rating scales in 82 patients underwent treatment for acute coronary syndrome in this cross-sectional observational study. The relationship of these psychological variables with gender, presence of diabetes mellitus, hypercholesterolemia and coronary revascularization were assessed. Statistical analysis was performed using unpaired t test for independent samples and Chi-square test Results: The majority of the patients were male (54 males and 28 females); the mean age of the patients was 61.9 ± 12.1 years; 46% were admitted for unstable angina, 37.8% for acute myocardial infarction (MI) with ST elevation, and 16.7% with non–ST-elevation MI. Depressive symptoms (HAM-D score>8) were present in 87.8% of the patients. The HAM-D score was closely related to the HAM-A and the HAM-PA scores (p<0.001). The HAM-D, HAM-A, and HAM-PA scores were significantly higher in female patients (p<0.001). After controlling for sex, both the HAM-D score (21.05 ± 7.72 vs 15.10 ± 7.3; p=0.02) and the HAM-A score (19.17 ± 9.50 vs 12.96 ± 7.77; p=0.03) were significantly higher in diabetic patients. The mean HAM-D score was also significantly higher in patients with hypercholesterolemia (18.10 ± 8.23 vs 13.97 ± 6.38; p=0.02), as well as in those with a previous history of cerebrovascular disease (CVD) (23.20 ± 9.62 vs 15.89 ± 7.45; p=0.02). Patients who had undergone coronary artery bypass grafting (CABG) showed significantly lower HAM-D (12.5 ± 7.8 vs 16.6 ± 8.1; p=0.03) and HAM-A (9.6 ± 6.3 vs 15.6 ± 8.5; p=0.01) scores. Conclusion: Higher scores of depression, anxiety, and panic agoraphobia were particularly common findings in female patients and in those patients with diabetes mellitus, hypercholesterolemia, and CVD. Depression and anxiety disorder may be prevalent in patients who had been treated for ACS. We believe that patients should be carefully followed and treated for depression and anxiety disorder after ACS treatment to prevent adverse outcomes.

Anahtar Kelime: Depressive Disorder Retrospective Studies Agoraphobia Myocardial Infarction Panic Disorder Psychiatric Status Rating Scales Diabetes Mellitus Hypercholesterolemia Anxiety Disorders

Konular: Kalp ve Kalp Damar Sistemi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	VURAl M, ACER M, AKBAŞ N (2008). The scores of Hamilton depression, anxiety, and panic agoraphobia rating scales in patients with acute coronary syndrome. , 43 - 47.
Chicago	VURAl Mutlu,ACER Mehmet,AKBAŞ NAZ BERFU The scores of Hamilton depression, anxiety, and panic agoraphobia rating scales in patients with acute coronary syndrome. (2008): 43 - 47.
MLA	VURAl Mutlu,ACER Mehmet,AKBAŞ NAZ BERFU The scores of Hamilton depression, anxiety, and panic agoraphobia rating scales in patients with acute coronary syndrome. , 2008, ss.43 - 47.
AMA	VURAl M,ACER M,AKBAŞ N The scores of Hamilton depression, anxiety, and panic agoraphobia rating scales in patients with acute coronary syndrome. . 2008; 43 - 47.
Vancouver	VURAl M,ACER M,AKBAŞ N The scores of Hamilton depression, anxiety, and panic agoraphobia rating scales in patients with acute coronary syndrome. . 2008; 43 - 47.
IEEE	VURAl M,ACER M,AKBAŞ N "The scores of Hamilton depression, anxiety, and panic agoraphobia rating scales in patients with acute coronary syndrome." , ss.43 - 47, 2008.
ISNAD	VURAl, Mutlu vd. "The scores of Hamilton depression, anxiety, and panic agoraphobia rating scales in patients with acute coronary syndrome". (2008), 43-47.

APA	VURAl M, ACER M, AKBAŞ N (2008). The scores of Hamilton depression, anxiety, and panic agoraphobia rating scales in patients with acute coronary syndrome. Anadolu Kardiyoloji Dergisi, 8(1), 43 - 47.
Chicago	VURAl Mutlu,ACER Mehmet,AKBAŞ NAZ BERFU The scores of Hamilton depression, anxiety, and panic agoraphobia rating scales in patients with acute coronary syndrome. Anadolu Kardiyoloji Dergisi 8, no.1 (2008): 43 - 47.
MLA	VURAl Mutlu,ACER Mehmet,AKBAŞ NAZ BERFU The scores of Hamilton depression, anxiety, and panic agoraphobia rating scales in patients with acute coronary syndrome. Anadolu Kardiyoloji Dergisi, vol.8, no.1, 2008, ss.43 - 47.
AMA	VURAl M,ACER M,AKBAŞ N The scores of Hamilton depression, anxiety, and panic agoraphobia rating scales in patients with acute coronary syndrome. Anadolu Kardiyoloji Dergisi. 2008; 8(1): 43 - 47.
Vancouver	VURAl M,ACER M,AKBAŞ N The scores of Hamilton depression, anxiety, and panic agoraphobia rating scales in patients with acute coronary syndrome. Anadolu Kardiyoloji Dergisi. 2008; 8(1): 43 - 47.
IEEE	VURAl M,ACER M,AKBAŞ N "The scores of Hamilton depression, anxiety, and panic agoraphobia rating scales in patients with acute coronary syndrome." Anadolu Kardiyoloji Dergisi, 8, ss.43 - 47, 2008.
ISNAD	VURAl, Mutlu vd. "The scores of Hamilton depression, anxiety, and panic agoraphobia rating scales in patients with acute coronary syndrome". Anadolu Kardiyoloji Dergisi 8/1 (2008), 43-47.