PSYCHOSOCIAL RESPONSES TO MULTIFACTOR CORONARY RISK REDUCTION (DEPRESSION, ANXIETY, ANGER, QUALITY OF LIFE, ADHERENCE).
Contributors: University of California, San Francisco.
Published: 1996
Number of pages: 164
Subjects: Health Sciences, Nursing.; Psychology, Physiological.
Description: Studies have found that negative emotional states such as depression, anxiety and anger are associated with low adherence, and health-related quality of life (HQOL), and higher risk for coronary artery disease (CAD) morbidity and mortality. Previous studies suggest that risk reduction may adversely affect quality of life. Multifactor coronary risk reduction (MRR) has been found to reduce CAD progression, morbidity and mortality, however, no studies have investigated the effect of MRR on negative emotional states or HQOL in patients randomly assigned to intensive MRR interventions. This study were to determined if: (1) ratings of depression, anxiety, anger, Type A behavior and HQOL differ in MRR as compared to usual care (UC); (2) pre-existing depression anxiety or anger is predictive of angiographic progression of CAD or clinical coronary events over four years, in a sample of patients with angiographically documented CAD, after controlling for pre-existing psychological factors, standard coronary risk factors, anginal symptoms, age and gender.

This study is a secondary analysis of data collected as a part of the Stanford Coronary Risk Intervention Project that randomized 259 men and 41 women with angiographic coronary artery narrowings of 5% to 70% to MRR or UC and had a four-year repeat angiographic assessment. These analyses report on 223 subjects with complete psychological and follow-up data.

This study found that participation in MRR did not effect the negative emotional states of depression, anger or anxiety. In men, MRR was related to significantly higher HQOL domains for physical functioning, and perceptions of health and well-being as compared to UC, however MRR was related to lower ratings of these HQOL domains in women. Univariate analysis found that pre-existing depression was associated with clinical coronary events. Multivariate linear regression analysis found that pre-existing anxiety was predictive of angiographic progression of disease. These results suggest that depression, anger and anxiety should be evaluated in CAD patients and treatment offered to reduce negative emotional states.
Notes: Source: Dissertation Abstracts International, Volume: 57-06, Section: B, page: 3654.

Thesis (PH.D.)--UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, 1996.

School code: 0034.