Age and sex determined differences in cognitive distortions and psychological traits in patients with coronary heart disease before coronary artery bypass surgery

Abstract

In patients with cardiovascular diseases, including CHD, the prevalence of anxiety and depression is considerable. Cognitive behavioral therapy is believed to be an effective tool for treating anxiety and depression. In the theory underlying cognitive behavioral psychotherapy, cognitive distortions play an important role. Cognitive distortions are misperception and misprocessing of information. Cognitive distortions are not a sign of mental disorders, however, their presence when assessing any situations (for example, while waiting for cardiac surgery) can lead to a range of psychological problems, in particular, to the development of anxiety and depression. Thus, the study of cognitive distortions in patients with cardiovascular diseases is of great importance in the view of the possibility of their negative impact on the mental state. Besides, according to the theoretical foundations of cognitive behavioral therapy, the presence of cognitive distortions also affects the interpersonal interaction (distorted perception of information, incorrect interpretation of behavior in the process of communication, etc.). Accordingly, the presence of cognitive distortions can also negatively affect patientdoctor interaction and adherence to treatment. The research aims to study the cognitive distortions and psychological characteristics of patients with CHD before CABG taking into consideration sex and age. The present study involved 60 patients with CHD, including 32 men (53%) and 28 women (47%). The average age of patients was 63 ± 8 years. Two groups of subjects were identified by age criterion: up to 65 years old and over 65 years old. To study cognitive distortions, the interview, and psychological testing (SCL-90-R and BIG 5 questionnaires) were carried out. All patients had different types of cognitive distortions. Men were more likely to spontaneous conclusions (37.5%), women were more likely to have overgeneralization (35%). In patients of the older age group (65<), the prevalence of dichotomous thinking was more frequent (25.92%). According to the results of the SCL-90-R questionnaire, women before CABG have higher indices of somatization, interpersonal sensitivity, and anxiety; men have higher indices of hostility. Patients over 65 years old have a higher level of somatization and depression. According to the results of the BIG 5 test, the majority of patients demonstrated a "below average" level in terms of "conscientiousness", "agreeableness", "openness to experience". For men, in terms of extraversion, the "above average" level was more common, while for women it was "level below average". When planning psychological testing and psychotherapy before CABG and during the rehabilitation, the identified psychological characteristics of patients and the specificity of cognitive distortions should be taken into account.