PSYCHOSOMATIC FEATURES AND DEPRESSION LEVEL IN CHRONIC HEART FAILURE IN PATIENTS WITH ARTERIAL HYPERTENSION AND ISCHEMIC HEART DISEASES

Abstract

Objective: to study the levels of depression, quality of life, personal and reactive anxiety in patients with chronic heart failure with hypertension and coronary heart disease. Material and methods. We examined 105 patients with coronary artery disease and hypertension with the manifestation of I-IV heart failure of functional classes according to the classification of the New York Heart Association. The level of depression was determined by the Beck Depression Inventory, the level of life quality was studied using the NAIF questionnaire (New Assessment and Information form to Measure Quality of life by P. Y. Hugenholtz and R. A. Erdman, 1995), personal and reactive anxiety was evaluated using Spielberg Hanina scale. The statistical analysis was performed using nonparametric tests: T-criteria of Mann-Whitney test, Spearman's rank correlation method, the data were processed with the program «Statistica», 6.0. Results. 39 patients (37.2 %) observed no depressive symptoms, 66 patients (62.8 %) detected depression of various degrees. 25 patients (41 %) observed mild depression, 26 (34.5 %) - moderate, 11 (18 %) - expressed, 4 people (6.5 %) - severe. Patients who had hypertension II-III and angina of the functional classes II and III more often suffered from depression, as well as patients with a combination of coronary heart disease and hypertension. The integral component of life quality was significantly reduced in patients with CHF FC I (73.8 ± 3.5 %), moderately reduced in patients with class II (62 ± 3.6%), significantly reduced in patients with FC III (44.2 ± 3.8%) and dramatically reduced in patients with IV FC (23.4 ± 3.8%). According to the nosological reasons, the integral indicator of life quality was lower in the patients who suffered hypertension II-III, angina FC II-III, as well as in those with a combination of hypertension and coronary heart disease. The level of reactive anxiety in all the groups of the patients did not exceed 45 points, that is, remained moderate and the reactive anxiety FC did not depend on chronic heart failure, angina and severity of arterial hypertension. At the same time we noticed a high rate of personal anxiety in the patients with FC II and CHF III in the patients with angina FC II-III, hypertension II-III and combination of angina and hypertension. Conclusion. 62.8 % patients with chronic heart failure revealed depressive disorders; cognitive-affective symptoms were prevalent in the patients with classes I and II of heart failure, somatic manifestations of depression - in the patients with FC III and IV of heart failure. Depressive disorders were associated with female sex (68 % women and 32 % men), age over 50 and the severity of somatic illness. The level of life quality decreases with increasing severity of CHF FC and somatic illness. The level of reactive anxiety in all the groups of the patients with chronic heart failure is moderate, the level of personal anxiety is high and is associated with the severity of heart failure and somatic illness, possibly because of the individual characteristics of a person and the influence of their medical condition.