Affiliation:
1. Mental Health Research Institute, Tomsk National Research Medical Center (TNRMC) of Russian Academy Sciences (RAS); Cardiology Research Institute, Tomsk National Research Medical Center (TNRMC) of Russian Academy Sciences (RAS)
2. Mental Health Research Institute, Tomsk National Research Medical Center (TNRMC) of Russian Academy Sciences (RAS)
3. Cardiology Research Institute, Tomsk National Research Medical Center (TNRMC) of Russian Academy Sciences (RAS)
Abstract
Objective:to identify the structure and clinical features of affective disorders (AD) and efficiency of antidepressants in in-patients with chronic coronary artery disease (ChCAD), living in Tomsk and the Tomsk Region.Materials andмethods.At a heart center, 1,131 patients with ChCAD were examined: in 290 persons (25.6%) AD were revealed, among them 72.1% were men (n= 209) and 27.9% were women (n= 81). Mean age of women was (63.5 ± 9.4) years and in men (57.9 ± 7.2) years (р= 0.004). AD structure, main syndromes, severity of depression and anxiety according to data of self-questionnaires and clinical scales before and after antidepressant therapy (predominantly with selective serotonin reuptake inhibitors (SSRI)) were studied. Comparative analysis of clinical indices of CAD respective from AD, presence of antidepressant therapy and its efficiency was performed.Results.Chronic AD were found in 45% of patients. Newly diagnosed depressive episodes made up 24.5% and recurrent depressive disorder (RDD) was 24%. 6.5% were bipolar affective disorders (BAD), predominantly bipolar II disorders. Depressive syndrome in 91.7% of patients had the second significant component (more frequently 54.8%). Characteristic of the clinical picture was dominance of complaints of bodily discomfort and pain, anergy and anhedonia. Moderate mental disturbances made up 49.0% (CGI). AD manifested at the age of 48 (40–55) years and preceded development of ChCAD. Natural course of AD was observed in 52.4% of cases. 47.6% (138/290) of patients received antidepressants, and only in 42% (58/138) clinically significant improvement was noted (more than 50% according to CGI). It was difficult to encourage patient adherence to long-term therapy (30–50% according to CGI). Physical activity tolerance (PAT) according to data of veloergometry increased in responders. Psychopharmaco- and psychotherapy should be included into rehabilitative programs for patients with ChCAD and AD.
Publisher
Siberian State Medical University
Reference12 articles.
1. Wuslin L., Vaillant G., Wells V. A systematic review of the mortality of depression. Psychosom. Med. 1999; 61 (1): 6–17. DOI: https://doi.org/10.1097/00006842-199901000-00003.
2. Kornetov A.N. Evaluation of depressive disorders of patients suffering from somatic illnesses in primary medicinal network. Rossiiskii psikhiatricheskii zhurnal – Russian Journal of Psychiatry. 2007; 1: 37–41 (in Russ.).
3. Kornetova Y.G., Semke A.V. Contemporary issues and perspectives on the studying of schizophrenia with negative symptoms leading. Byulleten’ sibirskoy meditsiny – Bulletin of Siberian Medicine. 2014; 13 (1): 5–13 (In Russ.). DOI: 10.20538/1682-0363-2014-1-5-13.
4. Frasure-Smith N., Lesperance F., Talajic M. Depression and 18-month prognosis after myocardial infarction. Circulation. 1995; 91(4): 999–1005. DOI: https://doi.org/10.1161/01.CIR.91.4.999.
5. Belokrylova M.F., Garganeeva N.P., Semke V.Ya., Lebedeva V.F., Epanchintseva E.M., Redchits O.A., Kostin A.K., Lucyanova E.V. Features of medical rehabilitation of patients with nonpsychotic mental disorders associated with physical diseases. Sibirskij vestnik psihiatrii i narkologii – Siberian Herald of Psychiatry and Addiction Psychiatry. 2011; 4: 78–84 (in Russ.).
Cited by
9 articles.
订阅此论文施引文献
订阅此论文施引文献，注册后可以免费订阅5篇论文的施引文献，订阅后可以查看论文全部施引文献