Depression is generally diagnosed through the core mood symptoms and a variety of associated emotional and physical symptoms that are persistent during a 2-week period. In primary care, the diagnosis of depression is complicated due to the combination of core mood symptoms and associated symptoms such as painful physical symptoms. 1,3-5 Among primary care patients, 65% of patients with MDD were shown to have some type of painful physical symptoms. 6,7 A greater severity of painful physical symptoms, including back pain, gastrointestinal pain, and headache, is associated with increased severity of depression and reduces quality of life. 8 The presence of painful physical symptoms in patients with depression impairs treatment outcome, 6,7 decreases remission rates, 9 and creates loss of productivity and quality of life. 3,4,10 Patients with residual symptoms, including painful symptoms, are more likely to relapse. 11 Pain in depression receives inadequate attention for treatment due to poor diagnosis. 12 Treatment of depression ideally should include both core mood symptoms and associated symp-
Goal: assessment of depressive symptomatology and personality traits in patients with coronary artery disease (CAD). Patients: forty-two males consecutively admitted to a cardiology unit due to an ICD-10 diagnosis of Acute Cardiac Syndrome (ACS). Twenty-two of them had unstable angina (UA) without myocardial infarction and 20 of them had confirmed myocardial infarction (MI). Methods: short questionnaire assessing the clinical course of heart disease, the Beck Depression Inventory (BDI) and the Cloninger Temperament and Character Inventory (TCI) were applied. Results: The mean BDI score in the whole group of patients was 20. The MI patients had higher BDI score than the UA patients without MI. The patients with more serious clinical course of heart disease and those who shorter suffered from ACS had significantly higher BDI score than the other patients. The whole group of ACS patients revealed more pronounced temperamental Harm Avoidance (HA) and less pronounced Reward Dependence dimension of the TCI. The patients with more serious clinical course of CAD had more evident HA features and than patients with mild clinical course of the disease. The patients with longer duration of CAD had more pronounced Self-Transcendence (a character dimension of the TCI) as compared to patients with shorter duration of the illness. Conclusions: Depressive symptoms are common and prominent in CAD patients particularly in those with shorter duration and more serious course of the illness. The relationships between temperamental and character dimensions of personality with the clinical course of CAD indicate multifactor and complex associations which need further studies.
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