Article is devoted to a research of interrelation of psychosocial factors and courses of coronary heart disease (CHD). The anxiety, a depression, social isolation of patients with CHD is considered. Need of identification of psychosocial factors at patients with CHD for the purpose of their correction and improvement of the forecast of sick CHD and quality of their life is shown.

Aim. To determine the sex specificities of medical and social parameters in patients hospitalized due to coronary artery disease (CAD), class II, III, IV angina, aged 35-60 years and assess the significance of their relationship with different levels of depression.Material and methods. The study involved 312 patients aged 35-60 with documented CAD, class II, III, IV angina. Two comparison groups were identified: group I — 138 patients (men, 81; women, 57) with CAD and without depression (mean age, 47,8±4,6 years); group II — 174 patients (men, 60; women, 105) with CAD and depression (mean age, 48,3±5,3 years). Medical and social data, the severity of depression and distress tolerance, psychological status and quality of life was assessed. Statistical analysis was carried out, which are presented as the mean and standard error of the mean (M±m). The odds ratio (OR) and 95% confidence interval (CI) were calculated. Differences were considered significant at p<0,05.Results. The prevalence of depression among patients with CAD was 55,77%, while women were 1,5 times more likely to suffer it than men. Depression was significantly associated with hyperglycemia, hypercholesterolemia, and class III-IV angina, regardless of sex. Class III and IV angina prevailed in women, while class II angina — in men (OR, 2,16; 95% CI, 1,37-3,41, p<0,001)). Women were more prone to degree II-III disability (group II, 26,67%; group I 8,77%; p=0,008), compared with men (group II, 27,54%; group I, 11,11%; p=0,012). Sedentary lifestyle was also associated to a greater extent with the female sex than with the male (OR, 2,89, 95% CI, 1,46-5,70, p=0,003; OR, 2,31, 95% CI, 1,19-4,48; p=0,014, respectively). Both men and women showed a significant association of depression with atherosclerosis (p<0,001), however, sex differences did not reach significance. Indicators such as lack of job and higher education, as well as smoking and arrhythmias were characteristic of both sexes, but had a greater impact on the mental condition of men (p=0,002, p<0,001, p=0,0014 and p=0,01, respectively). For men, the relationship of depression with diabetes (8,7 vs 0%; p=0,008), obesity (42,03 vs 19,75%; p=0,004), subordinate status (82,61 vs 64,2%; p=0,016) and unmarried status (60,87 vs 40,74%; p=0,02).Conclusion. There are significant differences in factors contributing to depression in different sex groups. The association of depression with CAD has an adverse effect on the physical and psychological health of both males and females. At the same time, women are more prone to mental disorders than men. It is necessary to further study the sex characteristics of medical and social parameters in order to personalize treatment methods.

ФГАОУ ВО "Первый Московский государственный медицинский университет им. И. М. Сеченова" Минздрава России (Сеченовский Университет)". Москва, Россия В статье отражена актуальность оценки медицинских, медико-социальных и психологических показателей, определяющих уровень качества жизни (КЖ) и риск развития депрессии у больных сердечнососудистыми заболеваниями. Установлено, что психологические расстройства оказывают отрицательное влияние на больных ишемической болезнью сердца (ИБС) и прогнозируют ухудшение общего здоровья и КЖ. Именно поэтому клинические проявления ИБС необходимо расценивать как последствие поведенческий реакций депрессивных больных. В ходе проведенного анализа сделан вывод о влиянии депрессии не только на здоровье пациента, но и на его психофизиологические особенности. В связи с этим, главным предметом изучения становится вопрос об отношении депрессии к появлению конкретных медико-социальных особенностей человека. Это обосновывает необходимость своевременного выявления депрессии и воздействия на совокупность психосоциальных факторов с целью повышения результативности комплексных лечебно-профилактических программ для больных ИБС и улучшения их КЖ. Ключевые слова: медико-социальные особенности, депрессия, качество жизни, оценка, ишемическая болезнь сердца, психосоциальные факторы.Конфликт интересов: не заявлен.

No abstract

No abstract