12. tbl 93. árg. 2007


Prevalence, diagnosis and treatment of depression and anxiety in patients in cardiac rehabilitation

Algengi, greining og meðferð þunglyndis og kvíða sjúklinga í hjartaendurhæfingu

Objective: The aim of this study was to estimate the prevelance of depression and anxiety among patients in cardiac rehabilitation at Reykjalundur Rehabilitation Center and to study the impact of a 4-5 weeks inpatient cardiac rehabilitation program on these symptoms. Secondly we wished to compare the concordance of our clinical diagnosis with the results of a standardized psychometric scale, Hospital Anxiety and Depression scale, HAD.

Materials and methods: Of 224 patients in one year, 200 (89.3%) were included in the study, 151 men and 49 women. The patients were first evaluated by a doctor and a nurse separately at the arrival and a clinical evaluation was made jointly. Shortly after arrival and before departure a HAD questionnaire was to be answered. All new psychiatric treatment was recorded.

Results: Prevalence of depression as measured by HAD was reduced from 9.5% to 3.1% and anxiety from 11.6% to 2.5%. The sensitivity of clinical diagnosis of depression as compared to the results of HAD was 73.7% and specificity 87.3%. For anxiety the sensitivity was 86.4% and specificity was 79.2%. The predicitive value of a positive clinical diagnosis of depressions was 37.8% and anxiety 33.9%, but predictive value of a negative clinical diagnosis was 96.9% and anxiety 97.9% respectively.

Conclusion: The prevalance of depression and anxiety is similar or somewhat lower than in other studies on patients with cardiac diseases. The agreement of clinical diagnosis and HAD questionnaire was acceptable and the questionnaire will not be used routinely. A comprehensive cardiac rehabilitation program seems to reduce substancially symtoms of depression and anxiety among patients in cardiac rehabilitation at Reykjalundur.

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