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Rivista di Psichiatria, Psicologia e Psicofarmacologia
Official Journal of the Italian Society of Social Psychiatry
Indexed/Abstracted in: EMBASE, e-psyche, PsycINFO, Scopus, Emerging Sources Citation Index
Minerva Psichiatrica 2015 December;56(4):165-70
Anxiety and depression in patients with arterial hypertension
Sakalyte G. 1, Adomaitiene V. 2, Karaliute R. 1, Urbonaite L. 1, Ceponiene I. 1, Baronaite-Dudoniene K. 1
1 Department of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania;
2 Department of Psychiatry, Lithuanian University of Health Sciences, Kaunas, Lithuania
AIM: Aim of the study was to determine the prevalence of anxiety and depression in patients with arterial hypertension (AH) and analyse the association with gender, age, education and co-morbid medical conditions.
METHODS: A study was performed in 13 outpatient clinics in Lithuania. It randomly enrolled 764 patients diagnosed with AH. They completed a self-administered questionnaire consisting of demographic characteristics (gender, age, education, body weight, blood pressure), self-reported medical history (diabetes, myocardial infarction and current smoking status), and symptoms of depression and anxiety. Anxiety and depression were measured by the Hospital Anxiety and Depression Scale (HADS).
RESULTS: Anxiety, depression and co-morbid disorders were observed in 22.4% (169), 7.4% (56) and 13.4% (101) of hypertensive patients, respectively. Males who had symptoms of anxiety were younger than females – 51.8±12.3 and 58.5±10.0 years, respectively (P=0.001). Anxiety and mixed anxiety and depression symptoms were more prevalent in females compared to males (74.6% [N.=127] and 78.2% [N.=79], respectively, P<0.05). Attained educational level was related to emotional status (χ²=35.33, P<0.001), i.e., depression was more prevalent in patients with secondary educational level – 28 (50%). HADS depression scores were higher for obese compared to non-obese patients (8.1±0.2 vs. 7.2±0.2, respectively, P=0.002) and HADS anxiety scores were higher for non-smokers compared to current or former smokers (9.5±0.2 vs. 8.7±0.2, respectively; P=0.007). Patients with combined symptoms of anxiety and depression were significantly more likely to have had myocardial infarction compared to those with normal emotional status (10.9% [N.=11] vs. 5% [N.=21]; P<0.05). Patients with long-lasting hypertension (≥10 years) were more likely to be depressed (N.=38 [9.9%]), anxious (N.=93 [24.4%]) or had combined anxiety and depression (N.=66 [17.3%]) compared to other individuals (P<0.05).
CONCLUSION: Anxiety, depression and co-morbid conditions are prevalent in hypertensive patients and are associated with age, gender, educational level and other heart disease risk factors, such as obesity. The association of mood disorders and hypertension is complex, with one increasing the likelihood of the other.