Сравнительные характеристики тревожно-депрессивных расстройств и их влияние на качество жизни больных с сердечно-сосудистыми заболеваниями в амбулаторном звене, в зависимости от гендерной принадлежности

Abstract

Aim. To evaluate the main parameters of indicators of anxiety and depressive disorders depending on gender, as well as its complex impact on the quality of life in outpatient patients with cardiovascular diseases. Materials and methods. The open prospective study included patients who were followed up on an outpatient basis at GAUZ TO “City Polyclinic No. 5” in Tyumen during 2016-2019. Everyone included in the study underwent generally accepted methods of clinical examination, as well as special methods of examination: determination of the N-Terminal fragment of the Brain Natriuretic Propeptide (NT-proBNP), assessment of points on the Hospital Anxiety and Depression Scale (HADS), the Morisky Green Test to determine adherence to treatment, conducting a personality psychotype test (DS-14), calculation of the number of points using a questionnaire to determine the quality of life (SF-36). Data analysis was carried out using statistical packages STATISTICA (version 22.0). For all analysis carried out, differences were considered significant at a two-tailed level of significance p < 0.05. Results. A total of 141 patients (44 men and 97 women, mean age 68.9 ± 8.8 years) were included in the study. When comparing the gender subgroups, it can be noted that women are characterized by higher levels of anxiety (7.0 (5.0-9.0) points vs. 4.0 (2.0-7.0) points in the male group, (p < 0.0001) and depression (7.0 (4.0-9.0) vs. 5.0 (2.75-7.25) points, p < 0.05) and a slightly more frequent occurrence of psychotype D (33% vs. 27.3% in the male group, p = 0.064). In the female group, there were correlations of the scales of anxiety and depression with indicators of quality of life, adherence to therapy. The indicator of the state of the cardiovascular system, estimated by the level of NTproBNP, directly correlated with age (r = 0.289, p = 0.006), the severity of anxiety (r = 0.336, p = 0.001) and depression (r = 0.314, p = 0.002). For the male subgroup, levels of anxiety and depression had no significant effect on quality of life, commitment, and NT-proBNP. In the male group, there was a negative relationship between the state of the cardiovascular system (assessed by the level of NTproBNP) and role functioning (r = –0.312, p = 0.042)., as well as – the emotional state (r = –0.325, p = 0.038). Conclusion. A more unfavorable state of the cardiovascular system, assessed objectively by the level of NT-proBNP, reduces role functioning and emotional state in men, and increases the level of anxiety and depression in women.