Psychological Stress in Myocardial Infarction Patients

Abstract

Abstract Background The interplay between mental and physical health is an area of inadequate research and hence poorly understood. However, decades of research have made surprising revelations—that both may actually cause each other—but the precise nature of these links is not clearly defined. Hence, the aim of this paper is to determine the prevalence of undiagnosed depressive and anxiety symptoms in patients presenting with Acute Myocardial Infarction (MI) in the Intensive Care Unit (ICU) of our hospital. Materials and Methods This is a cross-sectional study conducted on 100 patients admitted with acute MI in the cardiology ICU of our tertiary hospital. A detailed history was obtained, including socioeconomic history and complete medical history. The Perceived Stress Scale (PSS) was used to assess subjective psychological stress. Patient Health Questionnaire-9 (PHQ9) was used to diagnose unrecognized depression, and Generalized Anxiety Disorder-7 (GAD7) was used to identify anxiety disorder among patients. Results Out of total study population, 35% (n = 35) were females (mean age: 57.44 ± 13.54 years) and 65% (n = 65) were males (mean age: 55.90 ± 10.81 years). 82% (n = 82) of the patients were found to have subjective psychological distress, among which 70.73% (n = 58) patients had depressive symptoms, with 5.17% (n = 3) having major depression. Of the total patients diagnosed to have depression, 68.96% (n = 40) patients were males and 31.03% (n = 18) were females, with two out of three patients with major depression being females. Among the total study patients, 24% (n = 24) had anxiety symptoms, out of which 58.3% (n = 14) were males and 41.6% (n = 10) were females, with only two patients categorized as having severe anxiety disorder, both being females. Univariate analysis of study variables with depression showed that increased incidence of subjective psychological stress and lesser physical activity were strongly associated with depressive symptoms (P value: 0.04 and 0.01 respectively). Among the total study patients, 24% (n = 24) had anxiety symptoms out of which 58.3% (n = 14) were males and 41.6% (n = 10) were females, with only two patients categorized as having severe anxiety disorder, both being females. Univariate analysis of study variables with anxiety disorder showed significant association of older age > 60 years (P value 0.002), hypertension (HTN) (P value 0.001), T2DM (P value 0.02), and coexisting T2DM and HTN (P value 0.05), with anxiety disorder. Smoking and alcoholism also demonstrated an independent association with anxiety disorder (P value 0.04 and 0.01 respectively). Lesser physical activity demonstrated a strong association with anxiety (P value 0.0001). Conclusion The prevalence of psychological stress among MI patients is high, with depression existing in 70.7% of patients, notably, major depression was more in females. Of the total study population, 24% of patients had anxiety, where a severe degree of anxiety was more in female patients.