Features of coronary heart disease course in patients with depressive disorders

Multifactor risk for coronary heart disease (CHD) development is associated with susceptibility and depressive reaction to stressful situations that causes search for ways of optimization of integrative assistance to CHD patients with depressive disorders. Objective To carry out comparative analysis of dynamics of mental and physical state in CHD pateints. Material and methods Two hundred and eighty (57.74 ± 5.59 years) CHD patients with grade II–III angina pectoris were examined. Psychopathological method, Center of Epidemiological Studies-Depression scale (CES-D) were used. Results Ninety patients (32.1%) had depressive disorders within depressive episode, dysthymia, adjustment disorder. The level of depression according to CES-D varied from 19 to 28 points. Comparative analysis of two groups of patients showed that CHD patients with depression had more severe grade III angina (22.1% vs. 11.6%; P  = 0.036) more frequently. Differences regarding frequency of arterial hypertension (AH) (91.1% vs. 63.2%; P  = 0.0002), type 2 diabetes mellitus (DM) (26.8% vs. 17.5%; P  = 0.038), obesity (30.7 ± 3.9 vs. 29.5 ± 4.5; P  = 0.015), arrhythmias (34.4% vs. 25.2%; P  = 0.015); cases of myocardial infarction (47.8% vs. 17.9%; P  = 0.0001) were revealed. Among patients with depressive disorders persons with experience of surgical myocardial revascularization ( P  = 0.004), degree II–III of disability (23.3% vs. 11.6%; P  = 0.0118) were present more frequently. Patients with depression were characterized by low economic status (64.4% vs. 23.7%; P  = 0.0001); absence of social support (34.4% vs. 12.6%; P  = 0.0001); frequent stress situations in personal history (71.1% vs. 32.6%; P  = 0.0002). Conclusions Depressive disorders caused by psychosocial stress influence negatively CHD course that requires complex approach to therapy of comorbid pathology.