Depressive symptoms in patients with coronary artery disease after percutaneous coronary interventions (PCIs)
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Arch Psych Psych 2007;9(3):63-70
Introduction: Studies confirm a strong relationship between depression and coronary artery disease (CAD). Despite this, depressive disorders in CAD patients are often misdiagnosed and under-treated. Aim: 1) to investigate whether CAD patients qualified for percutanous coronary interventions (PCI) develop any specific type of depressive disorders; 2) to assess the depressive symptoms in CAD patients after the successful PCI. Subject and methods: of 227 CAD patients, qualified for PCI, 156 with optimal PCI result were included. Patients were assessed with the Hamilton Depression Rating Scale (HDRS), Beck Depression Inventory (BDI), Rosenberg Self-Esteem Scale (RS), Hopelessness Scale (HS), Automatic Thoughts Questionnaire (ATQ) one day before and 1 month after PCI. Results: The results were compared to the group of 49 depressed patients without CAD, treated in psychiatric setting (group III). Depressive symptoms, observed at the baseline in 75 patients (48.1% - group I) were of mild or moderate severity with the prevalence of somatic complains. A comparison between group I and group III revealed different characteristics of depressive symptomatology, while the severity of depression was comparable. One month after the PCI, depressive symptoms persisted in 33 subjects, in whom at the baseline BDI, ATQ and HS scores were significantly higher as compared to 42 patients in whom depressive symptoms resolved. Conclusions: Successful PCI is not a sufficient determinant for the improvement of depressive symptoms. Diagnosis of depression in CAD patients needs a special attention, because of a specific clinical picture and tendency to persistence.
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