Yurtseniuk O. Depressive and anxiety disorders in patients with coronary heart disease (diagnostic, clinical record, treatment and prevention)

The distribution of the clinical structure of depressive and anxiety disorders in patients with coronary heart disease (CHD) has shown that the predominant share belongs to a mild depressive episode (F 32.0) - 38.0 %, a mixed anxiety-depressive disorder (F 41.2) - 32.0 % and a moderate depressive episode (F 32.1) - 30.0 %. The following phenomena have the highest marked character within the pattern of depressive symptomatology (based of Hamilton's scale): general somatic symptoms - 1.81 points, reducedperformance efficiency and activity - 1.75 points, lethargy - 1.30 points, genital symptoms - 1.24 points, a depressive mood - 1.18 points. Among psychopathological symptoms the following ones predominate in patients with depressive and anxiety disoders (DADs): a depressive mood, sleep disturbances, a loss of interest in activity, a sense of fatigue, anxiety, gastrointestinal and genital symptoms. The onset and development of the clinical picture of DADs in patients with coronary heart disease (CHD) are influenced by: expressive accentuation of personality (emotive and struck types), high level of personality anxiety, situational anxiety, the duration of CHD of over 10 years as well as biological and social factors: the age older than 50 years,the level of education (secondary and secondary-special), the marital status and family relations (family conflicts), occupation (interpersonality conflicts at work, harmful professional and sanitary-technical conditions) a deterioration of the material-living conditions, financial difficulties, emotional overloads (p < 0.05), comorbid essential hypertension, overweight, insufficient motor activity (p < 0.05). The application of a developed method to differential therapy wich due regard for the above-mentioned personality factors and the clinical features of depressive and anxiety disorders in CHD patients significantly (p< 0.01) improve the efficiency of multimodality treatment (the therapeutic response increased 2.8 times: 0.90, 0.33 and 0.28, 0.1 respectively), confirming the expediency of its practical use.