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外周动脉疾病的心理因素研究:血运重建手术患者的情感气质、焦虑和抑郁

Examining Psychological Factors in Peripheral Artery Disease: Affective Temperament, Anxiety, and Depression in Patients Undergoing Revascularization Procedures.

作者信息

Chyrek-Tomaszewska Aleksandra, Popiołek Alicja Katarzyna, Piskunowicz Małgorzata, Borkowska Alina, Budzyński Jacek, Bieliński Maciej Kazimierz

机构信息

Department of Clinical Neuropsychology, Collegium Medicum of Nicolaus Copernicus University, Bydgoszcz, Poland.

Department of Cardiac Rehabilitation and Experimental Cardiology, Władysław Biegański's Regional Specialist Hospital, Grudziądz, Poland.

出版信息

Psychol Res Behav Manag. 2024 Jul 1;17:2533-2543. doi: 10.2147/PRBM.S463587. eCollection 2024.

Abstract

PURPOSE

This study aimed to assess the prevalence of depressive and anxiety symptoms in peripheral artery disease (PAD) patients, correlating these symptoms with clinical parameters and examining affective temperaments within the study group.

MATERIAL AND METHODS

A total of 159 PAD patients, predominantly male, admitted for vascular surgery due to lower limb atherosclerosis, participated in this cross-sectional study. Various assessments were conducted, including the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Autoquestionnaire (TEMPS-A) for affective temperaments, the Hospital Anxiety and Depression Scale (HADS) for anxiety and depression symptoms, and the Numerical Rating Scale (NRS) for pain intensity. Additionally, the Ankle-Brachial Index (ABI) was measured to assess circulation in the legs.

RESULTS

The findings revealed a higher prevalence of depressive and anxiety symptoms in the PAD patient group compared to the control group. Notably, depressive and anxiety symptoms correlated with the severity of PAD, as indicated by lower ABI values in the operated leg. Patients undergoing surgical revascularizations exhibited higher depressive symptoms than those undergoing endovascular procedures. Furthermore, correlations were observed between depressive symptoms and the number of previous vascular procedures and amputations, alongside increased pain levels at admission. Clinical factors such as diabetes, hypertension, heart failure, ischemic heart disease, previous revascularization procedures, amputations, and the intensity of affective temperaments did not correlate with HADS scores.

DISCUSSION

The study highlighted the intricate relationship between mood disorders and PAD severity, emphasizing the potential prognostic implications of untreated depression and anxiety in PAD patients. These findings suggest the importance of closely monitoring and addressing psychological well-being in PAD management. However, the study encountered limitations such as varying assessment timing and sample size discrepancies among comorbidities, impacting the observation of associations between mood disorders and certain conditions.

CONCLUSION

In conclusion, depressive and anxiety symptoms are often in PAD. Further research is needed to explore therapeutic interventions targeting mental health and pain management to improve the course and outcomes of PAD.

摘要

目的

本研究旨在评估外周动脉疾病(PAD)患者中抑郁和焦虑症状的患病率,将这些症状与临床参数相关联,并研究研究组内的情感气质。

材料与方法

共有159名因下肢动脉粥样硬化而接受血管手术的PAD患者(主要为男性)参与了这项横断面研究。进行了各种评估,包括用于情感气质的孟菲斯、比萨、巴黎和圣地亚哥气质评估问卷(TEMPS - A)、用于焦虑和抑郁症状的医院焦虑抑郁量表(HADS)以及用于疼痛强度的数字评分量表(NRS)。此外,测量了踝臂指数(ABI)以评估腿部血液循环。

结果

研究结果显示,与对照组相比,PAD患者组中抑郁和焦虑症状的患病率更高。值得注意的是,抑郁和焦虑症状与PAD的严重程度相关,手术侧较低的ABI值表明了这一点。接受手术血管重建的患者比接受血管内介入手术的患者表现出更高的抑郁症状。此外,观察到抑郁症状与既往血管手术和截肢的次数之间存在相关性,同时入院时疼痛程度增加。糖尿病、高血压、心力衰竭、缺血性心脏病、既往血管重建手术、截肢等临床因素以及情感气质的强度与HADS评分无关。

讨论

该研究突出了情绪障碍与PAD严重程度之间的复杂关系,强调了PAD患者中未治疗的抑郁和焦虑的潜在预后意义。这些发现表明在PAD管理中密切监测和关注心理健康的重要性。然而,该研究存在局限性,如评估时间不同以及合并症之间样本量存在差异,影响了对情绪障碍与某些情况之间关联的观察。

结论

总之,抑郁和焦虑症状在PAD中很常见。需要进一步研究探索针对心理健康和疼痛管理的治疗干预措施,以改善PAD的病程和结局。

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