Study On The Anxiety,Depression Of Patients With Coronary Heart Disease And The Relationship Between Quality Of Life And Anxiety,Depression

Objective To explore how was the situation of anxiety and/or depression disorder in the coronary heart disease patients in our investigations, and to investigate the risk factors of anxiety and depression.Meanwhile we tried to analyze the relationship between anxiety and depression disorder and quality of life(QOL) in patients with coronary heart disease in order to direct clinical treatment and improve QOL of the patients.Methods All cases were sampled from the First Affilliated of Anhui Medical University and the First People Hospital of Hefei from January to December in 2008,and the main parts are as following.1,In the first part we had the patients with all coronary heart disease finished the SAS/SDS scales.We explained the options of the scales to the patients if needed.We didn't explain any options of the scales to help the patients finished them at the first place.Meanwhile,none coronary heart disease patients were included as well as coronary heart disease patients, and there was no significant different between the two groups in basic data.2,In the second part,the Chinese Version of World Health Organization Quality of Life Assessment Instrument Brief Version(WHOQOL-BREF) was distributed to the patients of the first part, and to explore the relationship between the anxiety/depression and the quality of life among the patients with coronary heart disease.Results 1,①132 patients with coronary heart disease were included, obvious anxiety was present in 34.1 percent, obvious depression in 35.6 percent, among them, obvious anxiety in combination with obvious depression in 28.0 percent. ②The patients with CHD had significantly higher level of anxiety,depression condition than domestic normal people. The difference had statistic significance (P<0.001).③The rates of anxiety/depression in patients with acute coronary syndrome was significantly higher than patients with stable angina pectoris, (anxiety: 41.7% vs 27.8%, depression: 43.3% vs 29.2%).There was a significant difference of SAS/SDS scores between the patients with ACS and stable angina pectoris. The difference had statistic significance (P<0.001).④The statistic significance existed between gender,NYHA,caidiovascular diseases family history,day of stay,marriage condition,education level,level of hsCRP/vWF and the scores of SAS/SDS.And CHD patients'scores of anxiety was significantly in inversely correlated with scores of SDS(P<0.01).⑤Clinical symptoms such as insomnia, palpitation and fatigue are more obvious in coronary heart disease patients with anxiety and depression, and tend to have ischemic ST segment depression and obvious decrease of HRV.⑥The result of rehabilitation after leaving hospital three monthes:it is effective in coronary heart disease patients with anxiety and depression to be cured with psychological therapy and exercise intervention, the difference had statistic significance (P<0. 01)2,①The patients with CHD had significantly lower scores of the all indexs of quality of life than domestic normal people.The difference had statistic significance(P<0.01).And there's a difference of the scores of quality of life between the patients with ACS and stable angina pectoris. There are significant negative relativity between the scores of SAS and SDS and the scores of different components of WHOQOL-BREF.②Logistic regression analysis of quality of life of patients with coronary heart disease: age,NYHA,eduaction degree,marriage condition,the means of hospital fee paid,anxiety and depression,and days of stay have significant influence to the QOL of the patients with coronary heart disease.Conclusions There existed high prevalence of anxiety and depression disorders and more importance should be paid on the phenomenon.And there was relationship between anxiety, depression level and their living quality of patients with coronary heart disease.The study confirmde that anxiety and depression is a common psychosocial problem, which also applies to patients diagnosed with ACS, and ACS patients with anxiety and depression have rather worse quality of life.