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Bai B, Yin H, Guo L, Ma H, Wang H, Liu F, Liang Y, Liu A, Geng Q. Comorbidity of depression and anxiety leads to a poor prognosis following angina pectoris patients: a prospective study. BMC Psychiatry 2021; 21:202. [PMID: 33879109 PMCID: PMC8056494 DOI: 10.1186/s12888-021-03202-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 04/07/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Depression and anxiety are two common mood problems among patients with cardiovascular disease (CVD) and are associated with poor cardiac prognoses. The comorbidity of depression and anxiety is considered to be a more severe psychological status than non-comorbid mood disorders. However, little is known about the relationship between depression or anxiety and noncardiac readmission. We conducted a prospective study on the prognostic impact of depression, anxiety, and the comorbidity of the two among angina pectoris (AP) patients. METHOD In this prospective study, 443 patients with AP were included in the analysis. Follow-up assessments were performed 1 year, and 2 years after patient discharges. Clinical outcomes of interest included noncardiac readmission, major adverse cardiovascular events (MACEs), and composite events. Depression and anxiety symptom scores derived from the patient health questionnaire-9 (PHQ-9) and generalised anxiety disorder-7 (GAD-7) questionnaire were used to assess mood symptoms at baseline. Participants with symptom scores of ≥10 on both the depression and anxiety questionnaires formed the clinical comorbidity subgroup. We used multivariable Cox proportional hazards models to evaluate the impact of individual mood symptom and comorbidity on clinical outcomes. RESULTS Among all the AP patients, 172 (38. 9%) were determined to have depression symptoms, 127 (28.7%) patients had anxiety symptoms and 71 (16.0%) patients suffered from their comorbidity. After controlling covariates, we found that patients who endured clinical depression (hazard ratio [HR] = 2.38, 95% confidence interval [CI] 1.06-5.33, p = 0.035) and anxiety ([HR] 2.85, 95% [CI] 1.10-7.45, p = 0.032) had a high risk of noncardiac readmission. Compared to participants with no mood symptoms, those with clinical comorbidity of depression and anxiety presented a greater risk of noncardiac readmission ([HR] 2.91, 95% [CI] 1.03-8.18, p = 0.043) MACEs ([HR] 2.38, 95% [CI] 1.11-5.10, p = 0.025) and composite event ([HR] 2.52, 95% [CI] 1.35-4.69, p = 0.004). CONCLUSION Depression and anxiety were found to have predictive value for noncardiac readmission among patients with AP. Furthermore, prognoses were found to be worse for patients with comorbidity of depression and anxiety than those with single mood symptom. Additional attention needs to be focused on the initial identification and long-term monitoring of mood symptom comorbidity.
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Affiliation(s)
- Bingqing Bai
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshan Er Road, Yuexiu District, Guangzhou, 510080 People’s Republic of China
| | - Han Yin
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshan Er Road, Yuexiu District, Guangzhou, 510080 People’s Republic of China ,grid.79703.3a0000 0004 1764 3838School of Medicine, South China University of Technology, Guangzhou, People’s Republic of China
| | - Lan Guo
- Department of Cardiac Rehabilitation, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshan Er Road, Yuexiu District, Guangzhou, 510080 People’s Republic of China
| | - Huan Ma
- Department of Cardiac Rehabilitation, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshan Er Road, Yuexiu District, Guangzhou, 510080 People’s Republic of China
| | - Haochen Wang
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshan Er Road, Yuexiu District, Guangzhou, 510080 People’s Republic of China ,grid.79703.3a0000 0004 1764 3838School of Medicine, South China University of Technology, Guangzhou, People’s Republic of China
| | - Fengyao Liu
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshan Er Road, Yuexiu District, Guangzhou, 510080 People’s Republic of China ,grid.79703.3a0000 0004 1764 3838School of Medicine, South China University of Technology, Guangzhou, People’s Republic of China
| | - Yanting Liang
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshan Er Road, Yuexiu District, Guangzhou, 510080 People’s Republic of China ,grid.79703.3a0000 0004 1764 3838School of Medicine, South China University of Technology, Guangzhou, People’s Republic of China
| | - Anbang Liu
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, No.106 Zhongshan Er Road, Yuexiu District, Guangzhou, 510080 People’s Republic of China ,grid.79703.3a0000 0004 1764 3838School of Medicine, South China University of Technology, Guangzhou, People’s Republic of China
| | - Qingshan Geng
- Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong Cardiovascular Institute, No.106 Zhongshan Er Road, Yuexiu District, Guangzhou, 510080, People's Republic of China.
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Kuhlmann SL, Arolt V, Haverkamp W, Ströhle A, Waltenberger J, Müller-Nordhorn J, Rieckmann N. [Attitudes towards depression and treatment options in patients with coronary heart disease]. DER NERVENARZT 2019; 90:938-940. [PMID: 31098651 DOI: 10.1007/s00115-019-0736-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Stella L Kuhlmann
- Institut für Public Health, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Seestraße 73, 13347, Berlin, Deutschland.
- Arbeitsbereich Notfallmedizin (CVK, CCM), Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Deutschland.
| | - Volker Arolt
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Münster, Münster, Deutschland
| | - Wilhelm Haverkamp
- Medizinische Klinik mit Schwerpunkt Kardiologie, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Deutschland
| | - Andreas Ströhle
- Klinik für Psychiatrie und Psychotherapie, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Deutschland
| | - Johannes Waltenberger
- Department für Kardiologie und Angiologie, Universitätsklinikum Münster, Münster, Deutschland
| | - Jacqueline Müller-Nordhorn
- Institut für Public Health, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Seestraße 73, 13347, Berlin, Deutschland
| | - Nina Rieckmann
- Institut für Public Health, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Seestraße 73, 13347, Berlin, Deutschland
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Brinkers M, Pfau G, Schneemilch C. [Aspects of liaison psychiatry care of patients in a university pain clinic]. Schmerz 2019; 32:115-120. [PMID: 29352375 DOI: 10.1007/s00482-018-0267-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Owing to a rise of psychosomatic comorbidities, the treatment of psychological disorders, which may negatively impact prognosis and therapy, is increasingly becoming a focus of attention for pain outpatient clinics. AIM This study investigates and discusses the advantages of liaison psychiatric care in a university pain clinic. METHODS In this retrospective study, we investigated all patients who presented to an anaesthesiologically led pain clinic between January and June 2014. The psychiatric history was taken by the liaison psychiatrist of the pain clinic. RESULTS In the period investigated, 485 patients were treated as outpatients. A psychiatric diagnosis was present 351 patients (72.4%). The distribution of the diagnoses was comparable with that of a consultation service. Adaptation and affective disorders dominated. The patients were preferentially treated with new generation antidepressants. CONCLUSION The constant presence of a liaison psychiatrist allows for timely, specialised care of pain patients in terms of a multimodal therapeutic approach.
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Affiliation(s)
- M Brinkers
- Klinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Magdeburg A.ö.R., Leipziger Str. 44, 39120, Magdeburg, Deutschland.
| | - G Pfau
- Klinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Magdeburg A.ö.R., Leipziger Str. 44, 39120, Magdeburg, Deutschland
| | - C Schneemilch
- Klinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Magdeburg A.ö.R., Leipziger Str. 44, 39120, Magdeburg, Deutschland
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