Ramos I, Fernandez-Palacín F, Failde I
Preventive Medicine and Public Health Area, University of Cádiz, Spain.
Eur J Epidemiol. 2001;17(9):835-40. doi: 10.1023/a:1015614010877.
To identify the predictive factors of mental disorders in patients with suspected Ischaemic Cardiopathy (IC).
The patients admitted to the Cardiology Service of an University Hospital (SW Spain) for acute thoracic pain with suspected IC were studied. Patients were classified into four diagnostic groups (acute myocardial infarction, unstable angina, non-ischaemic cardiological process, non-cardiological) based on clinical, electrocardiographical and biochemical data. The sociodemographic and clinical variables were obtained by a 'ad hoc' questionnaire and the clinical records of the patient. The GHQ-28 questionnaire was used to assess the status of mental health, and a score of > or = 6 was taken as the cut-off point for being a 'probable psychiatric case'. Crude odds ratios (OR +/- 95% CI), and adjusted OR according to a logistic model, were calculated in order to study the variables associated with the mental disorders. The tabulation and analysis of data was carried out with the SPSS v.8 (for Windows) program.
From June 1996 to November 1997, 185 patients were studied; 72% were males and the mean age was 60.2 years (SD = 10.4). 49.2% of the patients were scored at > or = 6 on the GHQ-28, and the sub-scale accounting for the highest scores was that of somatic symptoms of psychological origin. The adjusted ORs showed that female sex (OR: 2.5; 95% CI: 1.2-5.0), previous personal history of IC (OR: 2.3; 95% CI: 1.1-4.4), and the presence of arterial hypertension (OR: 2.0; 95% CI: 1.1-3.9), were the predictive variables for being a 'probable psychiatric case', whereas neither age nor comorbidity were predictive.
The percentage of subjects considered to be a 'probable psychiatric case' among patients with suspected ischaemic cardiopathy was high. Screening for mental disorders and intervention to control the risk factors associated are measures recommended in these patients.
确定疑似缺血性心脏病（IC）患者精神障碍的预测因素。
对西班牙西南部一所大学医院心脏病科收治的因急性胸痛疑似IC的患者进行研究。根据临床、心电图和生化数据，将患者分为四个诊断组（急性心肌梗死、不稳定型心绞痛、非缺血性心脏疾病、非心脏疾病）。通过一份“特制”问卷和患者的临床记录获取社会人口学和临床变量。使用GHQ-28问卷评估心理健康状况，得分≥6分被视为“可能患有精神疾病”的临界点。计算粗比值比（OR±95%CI）以及根据逻辑模型调整后的OR，以研究与精神障碍相关的变量。使用SPSS v.8（Windows版）程序进行数据制表和分析。
1996年6月至1997年11月，共研究了185例患者；72%为男性，平均年龄为60.2岁（标准差=10.4）。49.2%的患者在GHQ-28上得分≥6分，得分最高的子量表是心理源性躯体症状量表。调整后的OR显示，女性（OR：2.5；95%CI：1.2 - 5.0）、既往有IC个人史（OR：2.3；95%CI：1.1 - 4.4）以及患有动脉高血压（OR：2.0；95%CI：1.1 - 3.9）是“可能患有精神疾病”的预测变量，而年龄和合并症均无预测作用。
疑似缺血性心脏病患者中被认为“可能患有精神疾病”的比例较高。对这些患者进行精神障碍筛查并采取干预措施以控制相关危险因素是推荐的措施。
