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The study of psychological features of males and females with coronary heart disease before coronary artery bypass surgery

The study of psychological features of males and females with coronary heart disease before coronary artery bypass surgery

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Recieved: 08/29/2019

Accepted: 11/08/2019

Published: 12/31/2019

p.: 92-101

DOI: 10.11621/npj.2019.0409

Keywords: coronary heart disease; coronary artery bypass surgery; anxiety; fatigue; depression; personality traits; psychopathological symptoms

Available online: 31.12.2019

To cite this article:

Velikanov Arseniy A., Stoljarova Anna A., Protasov Evgeniy A., Zelenskaya Irina A., Lubinskaya Ekaterina I., Terekhina Anastasiya A.. The study of psychological features of males and females with coronary heart disease before coronary artery bypass surgery. // National Psychological Journal 2019. 4. p.92-101. doi: 10.11621/npj.2019.0409

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Issue 4, 2019

Velikanov Arseniy A. Almazov National Medical Research Centre of the Ministry of Health of the Russian Federation

Stoljarova Anna A. Pavlov First State Medical University of St. Petersburg

Protasov Evgeniy A. Almazov National Medical Research Centre of the Ministry of Health of the Russian Federation

Zelenskaya Irina A. Almazov National Medical Research Centre of the Ministry of Health of the Russian Federation

Lubinskaya Ekaterina I. Almazov National Medical Research Centre of the Ministry of Health of the Russian Federation

Terekhina Anastasiya A. Almazov National Medical Research Centre of the Ministry of Health of the Russian Federation

Abstract

Background. Coronary heart disease (CHD) is a leading cause of disabilities and death. CHD is known to be a multifactorial disease and in the process of complex research, it is important to take into account the role of psychological factors. The presence of gender specificities in the formation and course of cardiovascular diseases determines the need to study the psychological characteristics of men and women with CHD in order to plan and develop prevention and rehabilitation programs.

Objective. The present research is aimed at studying the psychological features in men and women with CHD before coronary artery bypass grafting (CABG) at the stage of preoperative care: 1) the study of asthenic condition in patients with CHD (men and women) during inpatient treatment before CABG; 2) the study of the severity and structure of anxiety in patients with CHD (men and women) before CABG; 3) the study of psychopathological symptoms including depressive manifestations in patients (men and women) before CABG; 4) the study of personality peculiarities in patients with CHD before CABG.

Design. In the course of the present study 60 patients with CHD before CABG were surveyed with a gender distribution of 30 women and 30 men. The study was carried out on the basis of Almazov National Medical Research Centre of the Ministry of Health of the Russian Federation (St. Petersburg, Russia). The average age of patients was 60.9 ± 7.6. The study included the clinical interview and the following methods of psychological testing were used: Asthenic State Scale, Integrative Test of Anxiety (ITT), Symptom Check List-90-Revised, and The Big Five Personality Test.

Results. In women with CHD before CABG, the higher level of asthenia and anxiety (both state and trait) was found as compared with men. Also in women in comparison with male patients higher rates of such manifestations in the structure of their psychological features as “somatization”, “interpersonal sensitivity”, “depression”, “phobic anxiety” were noted. According to the results of the study of personality peculiarities, it was found that among men with CHD the indicator of emotional stability is higher than in women.

Conclusion. It is necessary to take into account the possible variants of a sensitive emotional response which may be more common in women at the stage of impatient treatment before CABG (including such manifestations as anxiety, low mood, emotional sensitivity, asthenia). In accordance with this, during psychocorrectional work, it is important to apply techniques aimed at working with those emotional-negative experiences that may worsen noticeably in connection with the upcoming surgical intervention.

Table 1. Results of the Integrative Test of Anxiety methodology, stanine

Integrative Test of Anxiety Subscale

Mean Total

Mean females

Mean males

Situational anxiety (scale of Situational Anxiety, SA)*

6.33±2.41

7.25±1.65

5.4±2.72

Emotional discomfort (SA)

6.13±2.56

6.55±2.52

5.7±2.6

Asthenic component (SA)*

6.1±2.4

7.5±1

4.65±2.56

Phobic component (SA)

5.1±2.9

5.65±3.27

4.5±2.48

Anxious Perspective Assessment (SA)

6.13±2.46

6.55±2.37

5.7±2.54

Social Protection Reactions (SA)*

5.58±2.57

6.55±2.56

4.6±2.23

Personal Anxiety (scale of Personal Anxiety. PA)*

6.55±1.77

7.55±1.32

5.55±1.61

Emotional discomfort (PA)*

6.73±1.98

7.75±1.41

5.7±1.95

Asthenic component (PA)*

6.28±2.23

7.05±2.14

5.5±2.09

Phobic component (PA)

5.25±2.08

5.85±2.35

4.65±1.63

Anxious Perspective Assessment (PA)*

6.53±1.89

7.4±1.70

5.65±1.69

Social Protection Reactions (PA)*

5.48±2.25

6.6±2.06

4.35±1.87

* – (р<0.01)

Table 2. Results of Symptom Check List-90-Revised, points

Symptom Check List-90-Revised) Subscale

Mean Total

Mean females

Mean males

Somatization (SOM)*

0.97±0.7

1.35±0.66

0.6±0.52

Obsessive-Compulsive (O–C)

0.94±0.6

1.11±0.61

0.78±0.56

Interpersonal Sensitivity (INT)*

0.85±0.72

1.16±0.69

0.54±0.61

Depression (DEP)*

0.93±0.6

1.2±0.6

0.66±0.48

Anxiety (ANX)*

0.96±0.79

1.35±0.78

0.57±0.6

Hostility (HOS)

0.5±0.49

0.36±0.42

0.64±0.52

Phobic Anxiety (PHOB)*

0.51±0.62

0.8±0.73

0.21±0.28

Paranoid Ideation (PAR)

0.34±0.33

0.4±0.39

0.28±0.25

Psychoticism (PSY)

0.23±0.21

0.24±0.2

0.22±0.22

Global Severity Index (GSI)*

0.68±0.43

0.86±0.42

0.5±0.37

Positive Symptom Distress Index (PSDI)

1.33±0.65

1.53±0.61

1.13±0.65

Positive Symptom Total (PST)*

37.3±14.1

43.65±12.93

30.95±12.5

* – (р<0.01)

References:

Aggarwal, N.R., Patel, H.N., Mehta, L.S., Sanghani, R.M., Lundberg, G.P., Lewis S.J., Mendelson, M.A., Wood, M.J., Volgman, A.S., & Mieres, J.H. (2018). Sex Differences in Ischemic Heart Disease. Circ Cardiovasc Qual Outcomes, 11(2). doi:10.1161/CIRCOUTCOMES.117.004437

AlBadri, A., Wei, J., Mehta, P.K., Shah, R., Herscovici, R., Gulati, M., Shufelt, C., & Bairey Merz, N. (2017). Sex differences in coronary heart disease risk factors: rename it ischaemic heart disease! Heart, 103(20), 1567–1568. doi:10.1136/heartjnl-2017-311921

Barbarash, O.L., Pomeshkina, S.A. (2015). Is rehabilitation necessary after coronary artery bypass grafting? [Kardiologiya i serdechno-sosudistaya khirurgiya], 8(1), 26–29. doi:10.17116/kardio20158126-29

Belyalov, F.I. (2017). Depression, anxiety and stress in patients with coronary heart disease. Therapeutic archive, 89 (8), 104-9. doi:10.17116/terarkh2017898104-109

Benjamin, E.J., Muntner, P., Alonso, A., Bittencourt, M.S., Callaway, C.W., Carson, A.P., Chamberlain, A.M., Chang, A.R., Cheng, S., Das, S.R., Delling, F.N., Djousse, L.,Elkind, M.S.V., Ferguson, J.F., Fornage, M., Jordan, L.C., Khan, S.S., Kissela, B.M., Knutson, K.L., Kwan, T.W., Lackland, D.T., Lewis, T.T., Lichtman, J.H., Longenecker, C.T., Loop, M.S., Lutsey, P.L., Martin, S.S., Matsushita, K., Moran, A.E., Mussolino, M.E., O’Flaherty, M., Pandey, A., Perak, A.M., Rosamond, W.D., Roth, G.A., Sampson, U.K.A., Satou, G.M., Schroeder, E.B., Shah, S.H., Spartano, N.L., Stokes, A., Tirschwell, D.L., Tsao, C.W., Turakhia, M.P., VanWagner, L.B., Wilkins, J.T., Wong,, S.S., & Virani, S.S. (2019). Heart Disease and Stroke Statistics-2019 At-a-Glance: on behalf of the American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics - 2019 update: a report from the American Heart Association. Circulation, 139(10), e56–e528. doi:10.1161/CIR.0000000000000659.

Bereznyak, J.S., & Seleznev, S.B. (2017). Clinical and psychological features of patients with coronary heart disease. Siberian Medical Journal, 32 (1), 8791. doi:10.29001/2073-8552-2017-32-1-87-91

Blumenfeld, O., Na'amnih, W., Shapira-Daniels, A., Lotan, C., Shohat, T., & Shapira, O. M. (2017). Trends in Coronary Revascularization and Ischemic Heart Disease-Related Mortality in Israel. Journal of the American Heart Association, 6(2), e004734. doi:10.1161/JAHA.116.004734

Bots, S.H., Peters, S.A.E., Woodward, M. (2017). Sex differences in coronary heart disease and stroke mortality: a global assessment of the effect of ageing between 1980 and 2010. BMJ Glob Health, 2(2). doi:10.1136/bmjgh-2017-000298.

Bykhovets, J., & Padun. M.A. (2019). Personal Anxiety and Emotion Regulation in the Context of Study of Post-Traumatic Stress. [Klinicheskaia i spetsial'naya psikhologiia], 8(1), 78–89. doi:10.17759/cpse.2019080105

Dubinina, E.A. (2018). Psychological aspects of rehabilitation of patients with myocardial infarction. Med. psihol. Ross., 10(2).

Garcia, M., Mulvagh, S.L., Merz, C.N.B, Buring, J.E., & Manson, E.J. (2016). Cardiovascular Disease in Women: Clinical Perspectives. Circulation Research, 118(8), 1273–93. doi:10.1161/CIRCRESAHA.116.307547

Grazhdan, I.K., Kopylov, F.Yu., Aksenova, M.G., Barskiy, V.I., & Kirillov, A.V. (2015). Pathogenetic relationship between personality traits and mental derangement with coronary heart disease. [Kardiologiya i Serdechno-Sosudistaya Khirurgia], (2), 8-20. doi:10.17116/kardio2015828-20

Humphries, K. H., Izadnegahdar, M., Sedlak, T., Saw, J., Johnston, N., Schenck-Gustafsson, K., … & Bairey Merz, C. N. (2017). Sex differences in cardiovascular disease - Impact on care and outcomes. Frontiers in neuroendocrinology, 46, 46–70. doi:10.1016/j.yfrne.2017.04.001

Kalinina, A.M. (2014). Multifactor primary prevention of ischemic heart disease in middle-aged men and its efficacy (10-year follow-up). Rational Pharmacotherapy in Cardiology, 10(1), 6–17. doi:10.20996/1819-6446-2014-10-1-6-17

Kalmykova, M.A., Elgarov, A.A., Apsheval, E.A., & Elgarov, M.A. (2015). Ischemic heart disease and atherosclerosis risk factors in women of different professions. Problems of women health, 10(4), 16-22.

Levashkevich, Yu.L., Velikanov, A.A., Yurlova, T.G., Isaeva, E.R., & Demchenko, E.A. (2015) Cognitive errors as a target of psychological correction in patients with coronary heart disease before and after coronary artery bypass grafting. Preventive and Clinical Medicine, 1(54), 110–114.

Lifintseva, A.A., Derkach, T.D., & Shtolde, N. (2018). Phenomenon of Uncertainty as a Subjective Experience. [Klinicheskaya i spetsial'naya psikhologiya], 7(1), 1–12. doi:10.17759/cpse.2018070101

Lysenko, A.V., Belov, Yu.V., Svidinskaya, E.A., Komarov, R.N., & Stonogin, A.V. (2016). Surgical treatment of coronary artery disease in postmenopausal women. Kardiologia i Serdechno-Sosudistaya Khirurgia, 9(6), 4–8. doi:10.17116/kardio2016964-8

McSweeney, J. C., Rosenfeld, A. G., Abel, W. M., Braun, L. T., Burke, L. E., & Daugherty, S. L., et al. (2016). American Heart Association Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, Council on Epidemiology and Prevention, Council on Hypertension, Council on Lifestyle and Cardiometabolic Health, and Council on Quality of Care and Outcomes Research. Preventing and Experiencing Ischemic Heart Disease as a Woman: State of the Science: A Scientific Statement From the American Heart Association. Circulation, 133(13), 1302–1331. doi:10.1161/CIR.0000000000000381

Nasiłowska-Barud, A., Zapolski, T., Barud, M., & Wysokiński, A. (2017). Overt and Covert Anxiety as a Toxic Factor in Ischemic Heart Disease in Women: The Link Between Psychological Factors and Heart Disease. Medical science monitor: international medical journal of experimental and clinical research, 23, 751–758. doi:10.12659/msm.902544

Omelyanenko, M.G., Shumakova, V.A., Sykhovei, N.A., Shchapova, N.N. (2014). Psychoemotional disorders and endothelial disfunction in cardiovascular diseases associated with atherosclerosis. The Siberian Medical Journal, 29(3), 18–24.

Piepoli, M.F., Hoes, A.W., Agewall, S., Albus, C., Brotons, C., & Catapano, A.L., et al. (2016). European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J., 37(29), 2315–2381. doi:10.1093/eurheartj/ehw106

Prado-Olivares, J., & Chover-Sierra, E. (2019). Preoperatory Anxiety in Patients Undergoing Cardiac Surgery. Diseases, 7(2):46. doi:10.3390/diseases7020046

Prokhorenko, I.O., Zarubina, E.G., Sergeev, O.S. & Sukhachev, P.A. (2016). Influence of psychological personality traits of elderly patients on the incidence, severity and dynamics of coronary heart disease. Bulletin of Medical Institute “REAVIZ”: Rehabilitation, Physician and Health, 3(23), 50–59.

Rafaeli, Y.R., Pankov, A.N., Rodionov, A.L., & Pekarskaya, M.V. (2018). Results of coronary bypass surgery of the arteries with extended atherosclerotic abnormalities. Almanac of Clinical Medicine, 46(7), 708–715. doi:10.18786/2072-0505-2018-46-7-708-715

Ramesh, C., Nayaka, B.S., Paib, V.B., Georgea, A., Georgea, L.S., Devi, E.S. (2017). Pre-operative anxiety in patients undergoing coronary artery bypassgraft surgery – A cross-sectional study. International Journal of Africa Nursing Sciences, 7, 31–36. doi:10.1016/j.ijans.2017.06.003

Richards, S. H., Anderson, L., Jenkinson, C. E., Whalley, B., Rees, K., Davies, P., … & Taylor, R. S. (2017). Psychological interventions for coronary heart disease: The Cochrane database of systematic reviews. Eur J Prev Cardiol., 25(3), 247–259. doi:10.1177/2047487317739978

Sidorov, K.R. (2013). Anxiousness as a psychological phenomenon. [Vestnik Udmurtskogo Universiteta], 2, 42-52.

Solodukhin, A.V., Bezzubova, V.A., Kuhareva, I.N., Inozemtseva, A.A., Seryy, A.V., Yanitskiy, M.S., Trubnikova, O.A., & Barbarash, O.L. (2017). The Relationship between Psychological Characteristics of the Attitude to the Disease, Coping Behavior of Patients with Ischemic Heart Disease, and their Cognitive Status. RUDN Journal of Psychology and Pedagogics, 14 (2), 178–189. doi:10.22363/2313-1683-2017-14-2-178-189

Solodukhin, A.V., Trubnikova, O.A., Yanitskiy, M.S., Seryy, A.V., & Barbarash, O.L. (2017). Clinical-psychological characteristics of patients with CHD before preparation for coronary bypass depending on their psycho-emotional status. Lechaschiy Vrach Journal, 11, 76–79.

Starodubova, A.V., Kislyak, O.A., & Chervyakova, Y.B. (2016). Coronary heart disease in women. International Heart and Vascular Disease Journal, 4(9), 10–15.

Starunskaya D.A., Velikanov A.A., Levashkevich J.L., Lubinskaya E.I., & Demchenko E.A. (2017). Psychological features in patients with coronary heart disease (men and women) prior to coronary artery bypass grafting depending on their involvement in the individual psycho-correction program. The Scientific Notes of the Pavlov university, 24(1), 58–61. doi:10.24884/1607-4181-2017-24-1-58-61

Taqueti, V. R. (2018). Sex Differences in the Coronary System. Advances in experimental medicine and biology, 1065, 257–278. doi:10.1007/978-3-319-77932-4_17

Vaccarino, V., & Bremner, J. D. (2017). Behavioral, emotional and neurobiological determinants of coronary heart disease risk in women. Neuroscience and biobehavioral reviews, 74(Pt B), 297–309. doi:10.1016/j.neubiorev.2016.04.023

Wilkins, E., Wilson, L., Wickramasinghe, K., Bhatnagar, P., Leal, J., Luengo-Fernandez, R., Burns, R., Rayner, M., & Townsend, N. (2017). European Cardiovascular Disease Statistics 2017. European Heart Network, Brussels

Zhang, M., Ma, C., Luo, Y., Li, J., Li, Q., Liu, Y., & Qiu, J. (2016). Neural basis of uncertain cue processing in trait anxiety. Scientific reports, 6, 21298. doi:10.1038/srep21298
To cite this article:

Velikanov Arseniy A., Stoljarova Anna A., Protasov Evgeniy A., Zelenskaya Irina A., Lubinskaya Ekaterina I., Terekhina Anastasiya A.. The study of psychological features of males and females with coronary heart disease before coronary artery bypass surgery. // National Psychological Journal 2019. 4. p.92-101. doi: 10.11621/npj.2019.0409

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