Investigation And Study Of The Psychosocial Factors In Patients With Coronary Artery Disease

Part I Study on the psychological status and its correlative factors in 1083 hospitalized patients with coronary artery disease qObjective To explore the prevalence and correlative factors of anxiety and depression symptoms in hospitalized Chinese patients with coronary artery disease(CAD). Methods Using a method of cross-sectional investigation, hospitalized patients who satisfied the diagnostic criteria of coronary artery disease were consecutively recruited. The ZUNG Self-rating Anxiety Scale (SAS) and the ZUNG Self-rating Depression Scale (SDS) were used for the psychological assessment. The patients'economic status, living condition and environment of the living and working places were investigated by epidemiological questionnaires. Student's t test, Chi-Square test and Binary Logistic Model (Forward stepwise) were adopted for data analysis. Results 1083 eligible subjects were recruited from June 2007 to May 2009. The prevalence of pure anxiety, pure depression symptoms and the combination of anxiety and depression symptoms were 7.9%,28.3% and 14.3% respectively. Female patients evidenced significantly higher rates of both anxiety and depression symptoms compared with their male counterparts (P=0.003, 0.012 respectively). The prevalence of anxiety symptom in elderly patients was significantly higher than that in non-elderly patients (P=0.001). The elderly, less than 9 years of education, and poor sleep quality increased the risk of anxiety symptom with ORs of 1.63(95%CI:1.21-2.21), 1.54(95%CI:1.15-2.07), and 1.62(95%CI: 1.34-1.96) respective1y; while workplace noise, history of chronic disease, and poor sleep quality increased the risk of depression symptom with ORs of 1.52(95%CI:1.18-1.98), 1.36(95%CI:1.06-1.75) and 1.27(95%CI:1.08-1.50) respectively. Female(OR=1.91, 95%CI:1.22-2.98), the elderly(OR=1.84, 95%CI:1.23- 2.76), workplace noise (OR=1.61, 95%CI:1.07-2.42), history of chronic disease(OR=1.84, 95%CI:1.24-2.71), and poor sleep quality(OR=1.73, 95%CI:1.35-2.21) were significantly correlated with the combination of anxiety and depression symptoms. Conclusion Around half of the Chinese hospitalized CAD patients were complicated with different degrees of anxiety and/or depression symptoms. Female and the elderly patients were at high risk to present the combination of anxiety and depression symptoms. Poor sleep quality, workplace noise, less than 9 years of education and history of chronic disease were correlated with the occurrence of anxiety or depression symptoms.Part II Study of the relationship between correlative factors and the extent and severity of coronary atherosclerosis in CAD patientsObjective To evaluate the correlation between psychosocial factors and the extent and severity of coronary atherosclerosis in CAD patients Methods Using a method of cross-sectional investigation, 944 hospitalized patients who satisfied the diagnostic criteria of coronary artery disease were consecutively recruited. The extent and severity of coronary atherosclerosis was assessed by the number of vessels obstructed≥50% in diameter and modified Gensini's severity score. The Self-rating Anxiety Scale (SAS) , the Self-rating Depression Scale (SDS) and the Social Support Scale (SSRS) were used for the psychosocial assessment. The Family Environment Scale-Chinese Version (FES-CV) for the family environment assessment. The patients' general conditions and life style were investigated by epidemiological questionnaires. One way analysis of variance (ANOVA), Kruskal-Wallis test and Mutiple regression analysis (Forward stepwise) were adopted for data analysis.Results Mutiple regression analysis showed HT (years) and age are the two prominent correlative factors of the extent and severity of coronary atherosclerosis ,but we can,t neglect other factors especiallly SDS score .Conclusion (1) It is very important to control risk factors including psychological factors in the intervention and prevention of CAD. (2) Distribution of risk factors and their severities vary in the extent and severity of coronary atherosclerosis, therefore the treatment of risk factors should be done differently.