Screening for symptoms of anxiety and depression in patients admitted to a university hospital with acute coronary syndrome

Abstract

Objective: To investigate the prevalence of anxiety and depression in patients admitted for acute coronary syndrome to a university hospital and to examine associations with use of psychotropic drugs. Methods: Ninety-one patients who had had an acute coronary event were enrolled on this cross-sectional prevalence study. Characteristics of the study population and the prevalence rates of depression and anxiety in the sample were assessed using the Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS) psychiatric consultation protocol, which includes clinical and sociodemographic data, and the Hospital Anxiety and Depression Scale (HADS). Results: The prevalence of symptoms of anxiety was 48.4% (44 patients) and the prevalence of depressive symptoms was 26.4% (24 patients). Of these, 19 patients (20.9% of the whole sample) had scores indicative of both types of symptoms concomitantly. Considering the whole sample, just 17 patients (18.7%) were receiving treatment for anxiety or depression with benzodiazepines and/or antidepressants. Conclusions: Anxiety and depression are disorders that are more prevalent among patients with acute coronary syndrome than in the general population, but they are generally under-diagnosed and under-treated. Patients with anxiety and depression simultaneously had higher scores on the HADS for anxiety and depression and therefore require more intensive care.

Factor structure of the Hospital Anxiety and Depression Scale in adolescent patients with chronic disease

“…14,17,[21][22][23][24][25][26] This is because it provides adequate information, is easily understood and can be administered in a short time. 27 Several publications have found adequate psychometric properties, [21][22][23][28][29][30] noting its appropriate internal consistency indices. 26,30 Its administration in children and adolescents, in populations other than the Spanish one, has displayed adequate psychometric properties for the overall emotional distress scale and for the HADS-A, but less robust for the HADS-D. 25,30 Likewise, studies conducted in this population have demonstrated that the HADS is a good predictor of anxiety and depression.…”

“…31 Differences are observed with other methods used in relation to its factor structure. 24 However, most authors have highlighted that the structure is made up of two factors both in adults 10,[21][22][23]29 and adolescents. [30][31][32] Although the HADS has been widely implemented worldwide in clinical practice and research, its use has been restricted to adults.…”

Hubungan Antara Depresi dan Ansietas Dengan Major Adverse Cardiac Event (MACE) Dalam 7 Hari Pada Pasien Sindrom Koroner Akut di RSCM

“…Terdapat beberapa prediktor terjadinya MACE pada pasien SKA, salah satunya adalah faktor psikologis yaitu depresi dan ansietas. 1,2 Melle, dkk. 3 pada sebuah meta-analisis tahun 2004 yang mengikutsertakan 22 studi dengan 6.000 pasien, melaporkan bahwa depresi post-infark miokard akan meningkatkan risiko terjadinya kematian dan serangan jantung berulang sebanyak 2-2,5 kali lebih besar.…”

La estructura factorial de la Escala hospitalaria de Ansiedad y Depresión en pacientes adolescentes con enfermedad crónica

“…Malestar emocional 0-6: normal-ausencia de ansiedad 0-5,4: normal-ausencia de depresión < 15,5: ausencia de diagnóstico clínico de malestar emocional 7-9: caso probable de ansiedad 5,5-7,5: caso probable de depresión ≥ 15,5: problema clínico de malestar emocional > 9: problema clínico de ansiedad > 7,5: problema clínico de depresión La mayoría de los estudios van en la línea de una solución bifactorial, 9,18,20,21,29 aunque, debido a las dudas acerca de la dimensionalidad de la escala, se plantea un modelo bifactorial con un factor de 2º orden (malestar emocional), y se señala que, en muestras adolescentes (adolescencia temprana y tardía), este tipo de trastornos emocionales (ansiedad y depresión) 2 pueden ser difíciles de diferenciar.…”

“…14,17,[21][22][23][24][25][26] Esto se debe a la información que aporta, a su fácil comprensión y a la corta duración de su aplicación. 27 S o n n u m e r o s a s l a s p u b l i c a c i o n e s q u e e n c u e n t r a n a d e c u a d a s p r o p i e d a d e s psicométricas, [21][22][23][28][29][30] que destacan índices de consistencia interna apropiados. 26,30 Su aplicación en niños y adolescentes, en poblaciones diferentes a la española, ha arrojado buenas propiedades psicométricas para la escala general de malestar emocional y para la HADS-A, aunque menos potentes psicométricamente para la HADS-D. 25,30 Asimismo, los estudios en esta población han mostrado como la HADS es un buen predictor para la clínica ansioso-depresiva.…”