Utilization of Mental Health Care, Treatment Patterns, and Course of Psychosocial Functioning in Northern German Coronary Artery Disease Patients with Depressive and/or Anxiety Disorders

Westermair, Anna Lisa; Schaich, Anja; Willenborg, Bastian; Willenborg, Christina; Nitsche, Stefan; Schunkert, Heribert; Erdmann, Jeanette; Schweiger, Ulrich

doi:10.3389/fpsyt.2018.00075

Cited by 8 publications

(4 citation statements)

References 32 publications

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“…Similar results of female predominance of depressive symptoms as well as higher incidence of anxiety and CAD were reported in a Chinese study [25]. Another large study in 514 German CAD patients, evaluated by the Mini International Neuropsychiatric Interview and the Global Assessment of Functioning (GAF) scale demonstrated comorbidity of depression with CAD and treatment of the depression resulted in improvement of this condition [26]. Interestingly, patients undergoing CABG operation, depression and anxiety were increased after the operation compared to the pre-operative period [27].…”

Section: Discussionsupporting

confidence: 81%

The impact of depression and anxiety in prognosis of patients undergoing myocardial perfusion imaging with 99mTc tetrofosmin SPECT for evaluation of possible myocardial ischemia

et al. 2020

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Background:The goal of this study was to evaluate the prevalence of depression and anxiety in patients subjected to myocardial perfusion imaging (MPI) with 99m Tc tetrofosmin stress-rest single-photon emission computer tomography (SPECT), and their impact on their cardiological events or disease. material and methods: Patients referred to the Nuclear Medicine Department for 99m Tc tetrofosmin myocardial MPI-SPECT were asked to fulfill the Zung Self-Rating Depression Scale (ZDS) and Hamilton anxiety questionnaire (HAQ). Among 213 patients who completed the ZDS and HAQ, 80 patients (59 males and 21 females) were selected for this study because they had no known psychological disease, other disease that could influence psychological status, or use of narcotic drugs. Collected data from MPI and psychological status were subsequently analyzed. results: Among all 80 patients, 52 patients (65%) had abnormal MPI of whom 28/52 (53.8%) exhibited either depression, anxiety or both, and 28 (35%) patients had normal MPI of whom 10/28 (35.7%) had abnormal psychological status. The higher number of patients with abnormal psychological status in association with abnormal MPI was noted predominantly in patients with previously established coronary artery disease. A correlation was also noted between obesity, cardiac heredity and depression or anxiety in patients with abnormal MPI. conclusions: Patients that exhibit depression, anxiety, or both, have high rates of myocardial ischemia, and thus are at risk for subsequent cardiological events.

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Section: Discussionsupporting

confidence: 81%

The impact of depression and anxiety in prognosis of patients undergoing myocardial perfusion imaging with 99mTc tetrofosmin SPECT for evaluation of possible myocardial ischemia

et al. 2020

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“…Lack of knowledge about the relevance of comorbid MD in CHD [ 6 , 14 , 15 ] may play a role. This may also depend on the type of MD, as Westermair et al [ 20 ] showed that the majority of CHD patients with comorbid depression received MD-related treatment, whereas there were deficits in diagnosis and treatment of comorbid anxiety disorders. Lack of trust in mental health care and stigmatising attitudes towards mental health on the part of physicians may also be involved [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

“…To date, research on the quality of health care and treatment trajectories of patients with CHD and comorbid MD has been limited and inconsistent. For instance, there is one study showing that health care of comorbid depression is treated well in patients with coronary artery disease, while there are shortcomings in the diagnosis and treatment of comorbid anxiety disorders [ 20 ]. In contrast, other studies show that there are also deficits in depression management [ 17 , 18 ], in the implementation of treatment recommendations and in the diagnosis and treatment of MDs in general [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Quality of health care for patients with coronary heart disease and comorbid mental disorders: a prospective cohort study

Nordmeyer,

Leikert,

Sannemann

et al. 2024

BMC Psychol

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Background Coronary heart disease (CHD) is often associated with mental disorders (MDs). Comorbid MDs reduce the quality of life and increase cardiac morbidity and mortality. Nevertheless, there is little and inconsistent research on the management of MDs in CHD patients. To bridge this gap, this study aims to gain insight into the long-term course of MD-related health care for patients with CHD, in order to identify opportunities for care improvement. Methods In this prospective cohort study, we investigated whether CHD patients with or without expert-rated MD at baseline (N = 364) received different MD-related health care from either their general practitioner (GP) or cardiologist at follow-up, M = 2.7 [2.0–4.0] years later. In the follow-up assessment, N = 131 CHD patients participated and received questionnaires capturing sociodemographic, mental health, and MD-related health care characteristics. Descriptive statistics, t-tests and chi-squared tests were used for analyses. Results We found significant differences in MD-related health care. CHD patients with MD were more likely to be examined psychologically/psychiatrically (MD 55.9%, non-MD 16.7%, p = < .001) and diagnosed with MD (MD 55.9%, non-MD 13.5%, p = .020) by their GP or cardiologist. Recommendations for and responses to requests for psychotherapy were more likely in MD patients compared to non-MD patients (MD 38.7%, non-MD 11.8%, p = .012 and MD 38.5%, non-MD 11.8%, p = .031, respectively). No significant differences were found concerning physicians’ active demand for patients’ mental health, referral to a specialist for additional diagnostics, provision of information about the diagnosed MD and further treatment options, response to the patients’ request for psychopharmacotherapy, help received in finding psychotherapy or psychopharmacotherapy, and actual receipt of these treatments. Conclusions The results indicate differences in MD-related health care of CHD patients with and without comorbid MD. However, they still highlight the need to further encourage primary care physicians treating CHD to adequately address MDs, provide further diagnostics, support, and information to affected patients. To address this, physicians may benefit from awareness training on the association between CHD and MDs and on appropriate communication with MD patients. Trial registration German clinical trials register (Deutsches Register Klinischer Studien, DRKS) Registration Number: ID DRKS00022154, date of registration: 02.11.2021.

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“…Psychological interventions, such as cognitive-behavioral therapy, interpersonal psychotherapy, and problem-solving therapy, have shown promise in reducing depressive symptoms, improving treatment compliance, and preventing relapse when combined with medication (113). These interventions have led to gradual improvements in the condition of CHD patients (114).…”

Section: Interventionsmentioning

confidence: 99%

Depression and coronary heart disease: mechanisms, interventions, and treatments

Xu,

Zhai,

Shi

et al. 2024

Front. Psychiatry

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Coronary heart disease (CHD), a cardiovascular condition that poses a significant threat to human health and life, has imposed a substantial economic burden on the world. However, in contrast to conventional risk factors, depression emerges as a novel and independent risk factor for CHD. This condition impacts the onset and progression of CHD and elevates the risk of adverse cardiovascular prognostic events in those already affected by CHD. As a result, depression has garnered increasing global attention. Despite this growing awareness, the specific mechanisms through which depression contributes to the development of CHD remain unclear. Existing research suggests that depression primarily influences the inflammatory response, Hypothalamic-pituitary-adrenocortical axis (HPA) and Autonomic Nervous System (ANS) dysfunction, platelet activation, endothelial dysfunction, lipid metabolism disorders, and genetics, all of which play pivotal roles in CHD development. Furthermore, the effectiveness and safety of antidepressant treatment in CHD patients with comorbid depression and its potential impact on the prognosis of CHD patients have become subjects of controversy. Further investigation is warranted to address these unresolved questions.

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Utilization of Mental Health Care, Treatment Patterns, and Course of Psychosocial Functioning in Northern German Coronary Artery Disease Patients with Depressive and/or Anxiety Disorders

Cited by 8 publications

References 32 publications

The impact of depression and anxiety in prognosis of patients undergoing myocardial perfusion imaging with 99mTc tetrofosmin SPECT for evaluation of possible myocardial ischemia

The impact of depression and anxiety in prognosis of patients undergoing myocardial perfusion imaging with 99mTc tetrofosmin SPECT for evaluation of possible myocardial ischemia

Quality of health care for patients with coronary heart disease and comorbid mental disorders: a prospective cohort study

Depression and coronary heart disease: mechanisms, interventions, and treatments

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