Key result
Coronary artery disease and valvular heart disease were associated with significantly higher global psychiatric severity indices (2.3 and 3.5, respectively) compared to healthy controls (1.1).
Case-Control (n=150)
Yes
Patients with coronary artery disease and valvular heart disease exhibit distinct psychopathological symptoms and temperament traits compared to healthy individuals, with certain symptoms inversely correlating with left ventricular ejection fraction.
Psychiatric screening may merit consideration in CAD/VHD; leaves open causality and requires prospective validation before practice change.
BACKGROUND: We aimed to investigate whether the psychopathological symptoms and temperament-character dimensions observed in patients operated due to coronary artery disease (CAD) or valvular heart disease (VHD) differ among the patients and from healthy individuals. METHODS: Study population was composed of subjects with CAD, VHD and healthy controls (n = 50 in each group). Socio-demographic questionnaire, temperament and character inventory (TCI) and symptom check list-90-R (SCL-90-R) were applied to all groups. Groups were compared about temperament-character dimensions and scores of subscales of SCL-90-R. RESULTS: Harm avoidance was found to be higher in VHD group than those with CAD and, lower in healthy controls than both patient groups (P = 0.004). Reward dependence was similar among both patient groups and, was higher than healthy group (P = 0.015). Depression, anxiety, somatization, obsession and interpersonal sensitivity were found to be similar in both patient groups but they were higher than those in controls (P < 0.001, P < 0.001, P < 0.001, P = 0.002 and P = 0.003, respectively). Phobia was seen equally in CAD group and healthy controls and, was found to be lower in these than in VHD (P = 0.009). Anger score was in descending order in patients with VHD, CAD and healthy controls group (P = 0.010 and 0.001). Paranoia was in descending order in patients with VHD, CAD and controls (P = 0.015 and 0.001). A weak and inverse correlation was found between ejection fraction (EF) and the persistence dimension of temperament scaled by TCI in patients with VHD (r = -0.276, P = 0.052). An inverse correlation was observed between EF and the reward dependence dimension in CAD group (r = -0.195, P = 0.044). In patients with VHD, EF demonstrated an inversely weak (r = -0.289, P = 0.042), moderate (r = -0.360, P = 0.010) and strong (r = -0.649, P < 0.001) correlation with inter-personal sensitivity, phobia and paranoia, respectively. There was an inverse and weak correlation between EF and depression and anger in VHD group (r = -0.302, P = 0.033 and r = -0.240, P = 0.054). CONCLUSION: VHD and CAD exhibit different psychopathological symptoms and temperament traits. There is a correlation between the aforementioned psychopathological symptoms and temperament traits, and EF.
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Bezgin et al. (2016) conducted a case-control in Coronary Artery Disease or Valvular Heart Disease (n=150). Coronary artery disease or valvular heart disease vs. Healthy controls was evaluated on Global severity index (SCL-90-R) (p=<0.001). Coronary artery disease and valvular heart disease were associated with significantly higher global psychiatric severity indices (2.3 and 3.5, respectively) compared to healthy controls (1.1).
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