Depressão e síndromes isquêmicas miocárdicas instáveis: diferenças entre homens e mulheres

Abstract

OBJECTIVEInvestigate whether social and demographic characteristics, clinical diagnosis, smoking status, alcohol consumption, and anxiety are associated with depression in patients with Acute Coronary Syndromes (ACS) stratified by gender. METHODSThree hundred forty-five consecutive patients with unstable myocardial ischemic syndrome (206 with myocardial infarction and 139 with unstable angina) were interviewed. The interviews included questions about sociodemographics, smoking status, screening for depression (Prime MD e BDI), trait and state anxiety, (IDATE), and alcohol consumption (AUDIT). RESULTSDiagnosis of depression has significantly correlated with female gender, age under 50 years, and higher average scores on trait anxiety and state anxiety. Depressed men (245) were usually younger than 50 years of age, smokers and had higher average score on trait anxiety and state anxiety than those non-depressed. The multivariate analysis highlights that age is negatively associated with depression (OR 0.9519 95% CI 0.9261 -0.9784) and that higher scores on trait anxiety are positively associated (OR 1.0691 95% CI 1.0375 -1.1017) with depression in the male gender. In the female sample (100), depressed women differ from nondepressed women in that they have a higher average score on trait anxiety and state anxiety. In the multivariate analysis of the female sample, a higher score on trait anxiety was independently associated with depression (OR 1.1267 95% CI 1.0632 -1.1940). CONCLUSIONIt was concluded that, among hospitalized patients with ACS, women, as well as men under 50 years and who suffer from anxiety are more likely to experience depression.

Psychological Approach to the Cardiac Arrhythmias: Focus on the Emotions

“…It occurs frequently associated with some type of loss, characterized by a behavioral inhibition, with decreased mobilization of the physiological resources (Kubzansky & Kawachi, 2000;Rozanski et al, 1999). Depression is twice as common among women (Lavoiea et al, 2001), among single people and those without close friends (Almeida & Fráguas Jr., 1996;Perez et al, 2005). Even with all the evidence associating depression to the cardiac diseases, cardiologists still have difficulties in making this association, because the somatic symptoms of fatigue, lack of energy, loss or increase in appetite and sleep disturbances are common and can be confused with symptoms of the cardiopathy (Perez et al, 2005).…”

“…Depression is twice as common among women (Lavoiea et al, 2001), among single people and those without close friends (Almeida & Fráguas Jr., 1996;Perez et al, 2005). Even with all the evidence associating depression to the cardiac diseases, cardiologists still have difficulties in making this association, because the somatic symptoms of fatigue, lack of energy, loss or increase in appetite and sleep disturbances are common and can be confused with symptoms of the cardiopathy (Perez et al, 2005). Not only is depression as a diagnostic entity related to disease.…”

“…The presence of depressive symptoms is also related to the occurrence of cardiac events (Rozanski et al, 1999) and increases the risk of mortality by between two and four times (Pinton et al, 2006). Depressive symptoms are significantly associated with psychological factors such as hopelessness, despondency, apathy, intolerance to frustration and cognitive distortions (Perez et al, 2005;Shnek et al, 2001;Sirois & Burg, 2003). Several studies have suggested that depression is associated with decreased survival in the short and long term in survivors of myocardial infarction (Pitzalis et al, 2001).…”

“…In other words, hormonal factors, genetic inheritance, differences in cerebral structure and function, and psychosocial factors seem to be associated with the prevalence of coronary disease among women. Among the psychosocial factors, the psychological style and mechanisms, the social and family role exercised by women, and social and professional changes are increasing highlighted (Perez et al, 2005). The climacteric stage, in turn, is related to various psychological symptoms and complaints, such as irritability, anxiety and depression, and these symptoms are exacerbated in women who have lost their social role and are unable to establish new existential goals (Favarato & Aldrighi, 2001).…”

Doença arterial coronariana e vivência de perdas

“…Cardiovascular diseases are indicated in literature as one of the most frequent causes of mortality in Western World, and the most important etiology of this group of diseases is human atherosclerosis, which is a chronic, progressive and systemic process, characterized by an inflammatory and fibroproliferative response in the arterial wall, caused by damage to the arterial surface 15,16 . CAD and depression, both diseases which seriously affect health, due to their high prevalence and their impact in mortality and the quality of life, present clinical evidences that indicate the existence of a close relationship between them 17 .…”