Effect of depression and anxiety on quality of life among cardiovascular patients visiting Tertiary Care hospital Lahore
Effect of depression and anxiety on QoL among cardiovascular patients
DOI:
https://doi.org/10.54393/pbmj.v4i2.98Keywords:
Cardiovascular disease patients, anxiety, depression, quality of life.Abstract
Cardiovascular diseases (CVD) are the leading cause of death worldwide. Mental disorders like anxiety and depression are common among cardiovascular patients. These mental disorders have adverse effect on quality of life (QoL) among these patients which further increases mortality and morbidity among them Objective: The propose of this study was to assess the effect of anxiety and depression on quality of life among cardiovascular patients Methods: A cross sectional study was performed at Sir Ganga Ram Hospital Lahore. 100 patients of CVD were selected by non-probability sampling technique. All patients of both genders aged above 18 years with diagnosed CVD were included. In order to measure the anxiety and depression among cardiovascular patients, Hospital Anxiety and Depression Scale (HADS) and WHOQOL was used to assess the QoL of patients Results: Out of total 100 patients, there were 47 females and 53 males. Patients mean age was 54.87 ± 16.66. Among CVD patients, 52 were borderline cases and 33 were abnormal cases of anxiety. 56 cases were borderline and 28 were abnormal cases of depression. Anxiety and depression had adverse effect on QoL among CVD patients. Low scores were found for physical, psychological and environmental domains of WHOQOL. A significant association was found between social relationships domain of WHOQOL with anxiety and depression and the level of significance was p-values 0.016 and 0.043 respectively. There was significant association between psychological domain of QoL with depression (P=0.039) and monthly income (P=0.016). There was insignificant association between educational level, sex, age with QoL, anxiety and depression Conclusions: Study concluded that anxiety and depression have negative impact on QoL and are risk factors for health-related QoL among CVD patients. Persons attending medical care are usually not being assessed for anxiety due to lack of facilities, lack of understanding of disease and over burden of patients. They are responsible for greater mortality and morbidity in CVDs. The depression and Anxiety are the mediating factors and it must be taken into consideration in clinical practices when QoL is considered as a clinical prerequisite
References
Murray CJ, Lopez AD, World Health Organization. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020: summary. https://digitallibrary.un.org/record/195443?ln=en
De Hert M, Detraux J, Van Winkel R, Yu W, Correll CU. Metabolic and cardiovascular adverse effects associated with antipsychotic drugs. Nat. Rev. Endoc. 2012 Feb; 8(2):114.
https://doi.org/10.1038/nrendo.2011.156
Skarl S. Anxiety and Depression Association of America. J. Consu. Hlth. Intnt. 2015 Apr 3; 19(2):100-6. https://doi.org/10.1080/15398285.2015.1035595
Ouakinin SR. Anxiety as a Laslett LJ, Alagona P, Clark BA, Drozda JP, Saldivar F, Wilson SR, Poe C, Hart M. The worldwide environment of cardiovascular disease: prevalence, diagnosis, therapy, and policy issues: a report from the American College of Cardiology. J. Amer. Col. Cardio. 2012 Dec 25 doi: 10.1016/j.jacc.2012.11.002
Elderon L, Whooley MA. Depression and cardiovascular disease. Progress in cardiovascular diseases. 2013 May 1;55(6):511-23. https://doi.org/10.1016/j.pcad.2013.03.010
Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS med. 2006 Nov 28;3(11):e442. https://doi.org/10.1371/journal.pmed.0030442
Raison CL, Capuron L, Miller AH. Cytokines sing the blues: inflammation and the pathogenesis of depression. Trends in immunology. 2006 Jan 1;27(1):24-31.
https://doi.org/10.1016/j.it.2005.11.006
Bonnet F, Irving K, Terra JL, Nony P, Berthezène F, Moulin P. Anxiety and depression are associated with unhealthy lifestyle in patients at risk of cardiovascular disease. Atherosclerosis. 2005 Feb 1;178(2):339-44. https://doi.org/10.1016/j.atherosclerosis.2004.08.035
Chung ML, Moser DK, Lennie TA, Rayens MK. The effects of depressive symptoms and anxiety on quality of life in patients with heart failure and their spouses: Testing dyadic dynamics using Actor-Partner Interdependence Model. J. psych. Res. 2009 Jul 1;67(1):29-35. https://doi.org/10.1016/j.jpsychores.2009.01.009
Cully JA, Phillips LL, Kunik ME, Stanley MA, Deswal A. Predicting quality of life in veterans with heart failure: the role of disease severity, depression, and comorbid anxiety. Behavioral Medicine. 2010 May 26;36(2):70-6. https://doi.org/10.1080/08964280903521297
Arif A, Naveed S, Aslam R. Factors causing stress among Pakistani working women. Pakistan Administrative Review. 2017;1(3):159-74. https://www.prdb.pk/article/factors-causing-stress-among-pakistani-working-women-789
Abbasi IN, Gajoo DH, Kumar S, Zainab SZ, Fatmi Z. Pattern of cardiovascular diseases according to age and gender in a rural district of Pakistan. Pak. Heart J. 2013 Sep 11;46(3). https://www.semanticscholar.org/paper/PATTERN-OF-CARDIOVASCULAR-DISEASES-ACCORDING-TO-AGE-Abbasi-Gajoo/76efd933ace175f521b0695180fed83fd2458136
Dogar IA, Khawaja IS, Azeem MW, Awan H, Ayub A, Iqbal J, Thuras P. Prevalence and risk factors for depression and anxiety in hospitalized cardiac patients in Pakistan. Psychiatry (Edgmont). 2008 Feb;5(2):38. https://pubmed.ncbi.nlm.nih.gov/19727293/
Kyrou I, Kollia N, Panagiotakos D, Georgousopoulou E, Chrysohoou C, Tsigos C, Randeva HS, Yannakoulia M, Stefanadis C, Papageorgiou C, Pitsavos C. Association of depression and anxiety status with 10-year cardiovascular disease incidence among apparently healthy Greek adults: the ATTICA study. Euro. J. prev. cardio. 2017 Jan;24(2):145-52.
https://doi.org/10.1177/2047487316670918
Hamrah MS, Hamrah MH, Ishii H, Suzuki S, Hamrah MH, Hamrah AE, Dahi AE, Takeshita K, Yisireyili M, Hamrah MH, Fotouhi A. Anxiety and Depression among Hypertensive Outpatients in Afghanistan: A Cross-Sectional Study in Andkhoy City. Int. j. hyper. 2018.
https://doi.org/10.1155/2018/8560835
Kemp AH, Quintana DS, Felmingham KL, Matthews S, Jelinek HF. Depression, comorbid anxiety disorders, and heart rate variability in physically healthy, unmedicated patients: implications for cardiovascular risk. PloS one. 2012 Feb 15;7(2):e30777.
https://doi.org/10.1371/journal.pone.0030777
Hallas CN, Wray J, Andreou P, Banner NR. Depression and perceptions about heart failure predict quality of life in patients with advanced heart failure. Heart & lung. 2011 Mar 1; 40(2):111-21. https://doi.org/10.1016/j.hrtlng.2009.12.008
Frasure-Smith N, Lespérance F. Depression and anxiety as predictors of 2-year cardiac events in patients with stable coronary artery disease. Arch. Gen. psych. 2008 Jan 1;65(1):62-71. https://doi.org/10.1001/archgenpsychiatry.2007.4
Dickens C, Cherrington A, McGowan L. Do cognitive and behavioral factors mediate the impact of depression on medical outcomes in people with coronary heart disease? J. cardio. Rehab. Prev. 2011 Mar 1;31(2):105-10. https://doi.org/10.1097/HCR.0b013e318207d32b
Lerner DJ, Kannel WB. Patterns of coronary heart disease morbidity and mortality in the sexes: a 26-year follow-up of the Framingham population. Ame. heart j. 1986 Feb 1;111(2):383-90. https://doi.org/10.1016/0002-8703(86)90155-9
Maas AH, Appelman YE. Gender differences in coronary heart disease. Netherlands Heart J. 2010 Nov 1;18(12):598-603. https://doi.org/10.1007/s12471-010-0841-y
Ko HY, Lee JK, Shin JY, Jo E. Health-related quality of life and cardiovascular disease risk in Korean adults. Kor. j. fam. Med. 2015 Nov;36(6):349. https://doi.org/10.4082/kjfm.2015.36.6.349
Çeviker K, Şahinalp Ş, Çiçek E, Demir D, Uysal D, Yazkan R, Akpınar A, Yavuz T. Quality of life in patients with chronic venous disease in Turkey: influence of different treatment modalities at 6-month follow-up. Quality of Life Research. 2016 Jun 1;25(6):1527-36. https://doi.org/10.1007/s11136-015-1180-7
Lim L, Jin AZ, Ng TP. Anxiety and depression, chronic physical conditions, and quality of life in an urban population sample study. Social psychiatry and psychiatric epidemiology. 2012 Jul 1;47(7):1047-53. https://doi.org/10.1007/s00127-011-0420-6
Ola BA, Adewuya AO, Ajayi OE, Akintomide AO, Oginni OO, Ologun YA. Relationship between depression and quality of life in Nigerian outpatients with heart failure. J. psycho. Res. 2006 Dec 1;61(6):797-800. https://doi.org/10.1016/j.jpsychores.2006.04.022
Juenger J, Schellberg D, Kraemer S, Haunstetter A, Zugck C, Herzog W, Haass M. Health related quality of life in patients with congestive heart failure: comparison with other chronic diseases and relation to functional variables. Heart. 2002 Mar 1;87(3):235-41. https://doi.org/10.1136/heart.87.3.235
Jiang W, Alexander J, Christopher E, Kuchibhatla M, Gaulden LH, Cuffe MS, Blazing MA, Davenport C, Califf RM, Krishnan RR, O'Connor CM. Relationship of depression to increased risk of mortality and rehospitalization in patients with congestive heart failure. Archives of internal medicine. 2001 Aug 13;161(15):1849-56. https://doi.org/10.1001/archinte.161.15.1849
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