Serber Eva R, Todaro John F, Tilkemeier Peter L, Niaura Raymond
Center for Behavioral Medicine, The Miriam Hospital & Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island 02903, USA.
J Cardiopulm Rehabil Prev. 2009 May-Jun;29(3):161-8; quiz 169-70. doi: 10.1097/HCR.0b013e3181a33365.
Anxiety and depressive disorders have been established as independent risk factors for the development of and recovery from coronary heart disease (CHD). However, few studies have reported on the prevalence and personal characteristics of comorbid psychiatric disorders (PD) among cardiac populations. This project examined the prevalence of comorbid depressive and anxiety disorders among men and women with CHD commencing cardiac rehabilitation (CR) and the demographic, medical, and psychosocial characteristics among those meeting multiple PD criteria.
Participants were 143 CHD patients (M age, 61 years; SD, 11.2; 70% men, 91% Caucasian, 64% married) entering CR who were evaluated via a semistructured, psychiatric interview to assess both current and lifetime prevalence rates of PD. Demographic, medical, and psychosocial variables were also assessed.
Approximately 45% met criteria for at least 1 anxiety disorder, and 20% met criteria for either major depressive disorder or dysthymic disorder either at the time of evaluation or in their lifetime. Across all participants, 26% met criteria for >or=2 PD. Of those with a depressive disorder, 76% also met criteria for at least 1 anxiety disorder. Participants with comorbid PD were of younger age and female and reported less education (P < .01). Comorbidity was also associated with self-reported overall diminished physical, emotional, and social quality of life, depression, and anxiety.
Comorbid PD are highly prevalent in the CR setting and are associated with specific demographic characteristics and reduced quality of life. These data offer additional support that routine screening for PD is warranted in outpatient cardiac settings.
焦虑症和抑郁症已被确认为冠心病(CHD)发生和康复的独立危险因素。然而,很少有研究报道心脏疾病人群中共病精神障碍(PD)的患病率及个人特征。本项目调查了开始心脏康复(CR)的冠心病男性和女性患者中共病抑郁和焦虑症的患病率,以及符合多种PD标准者的人口统计学、医学和社会心理特征。
研究对象为143例进入CR的冠心病患者(平均年龄61岁;标准差11.2;70%为男性,91%为白种人,64%已婚),通过半结构化精神科访谈对其进行评估,以确定PD的当前患病率和终生患病率。同时还评估了人口统计学、医学和社会心理变量。
约45%的患者符合至少1种焦虑症标准,20%的患者在评估时或一生中符合重度抑郁症或心境恶劣障碍标准。在所有参与者中,26%符合≥2种PD标准。在患有抑郁症的患者中,76%也符合至少1种焦虑症标准。共病PD的参与者年龄较小,女性居多,且受教育程度较低(P<0.01)。共病还与自我报告的整体身体、情感和社会生活质量下降、抑郁和焦虑有关。
共病PD在CR环境中非常普遍,且与特定的人口统计学特征和生活质量下降有关。这些数据进一步支持在门诊心脏科进行PD的常规筛查。