Indian Journal of PsychiatryIndian Journal of Psychiatry
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ORIGINAL ARTICLE
Year : 2018  |  Volume : 60  |  Issue : 1  |  Page : 60-64

Psychiatric comorbidities in acute coronary syndromes: Six-month follow-up study


1 Department of Psychiatry, JSS Medical College Hospital, JSS Academy of Higher Education and Research, Formerly JSS University, Mysuru, Karnataka, India
2 Department of Cardiovascular and Thoracic Sciences, JSS Medical College Hospital, JSS Academy of Higher Education and Research, Formerly JSS University, Mysuru, Karnataka, India

Correspondence Address:
Prof. T S Sathyanarayana Rao
Department of Psychiatry, JSS Medical College, JSS Academy of Higher Education and Research, Formerly JSS University, Mysuru, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/psychiatry.IndianJPsychiatry_94_18

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Introduction: Acute coronary syndrome (ACS) caused by coronary atherosclerosis include ST-segment elevation myocardial infarction (STEMI), non-STEMI, and unstable angina. The relation between psychiatric disorders and coronary artery disease is a complex one which includes the effect of the psychosocial factors on heart and vice versa. Point prevalence studies have been reported, but there is paucity of follow-up studies from India. Materials and Methods: The study is a follow-up evaluation at discharge of 248 consecutive patients presented with ACS at JSS Hospital, Mysuru, Karnataka, over a period of 6 months to assess the psychiatric comorbidities. The patients were assessed on a structured and validated pro forma before discharge, at 3 months, and at 6 months. Screening of psychiatric disorders was done using Mini International Neuropsychiatric Interview PLUS 5.0.0 and assessment of depression was done using Hamilton Depression Rating Scale. ANOVA, Student's t-test, and SPSS 21 were used for statistical analysis. Results: The most common psychiatric comorbidities include major depressive disorder (44%), it persisted at the end of 3 (P < 0.001) and 6 (P < 0.001) months. A spectrum of anxiety disorders including panic disorder (12.10%), dysthymia (3.60%), agoraphobia (2.40%), social phobia (2%), obsessive-compulsive disorder (1.6%), specific phobia (1.2%), and posttraumatic stress disorder (0.8%) in descending order at the end of 6 months were found. Significant reduction in substance use of nicotine (66.1%) and alcohol (56.0%) was reported on follow-up. Conclusion: Depression, anxiety, and substance use occur in patients with ACS which persist on follow-up. Early recognition at discharge and appropriate counseling on follow-up improve the clinical outcomes.



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