[Prevalence, diagnosis and treatment of depression and anxiety in patients in cardiac rehabilitation].
OBJECTIVE
The aim of this study was to estimate the prevalence 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.


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 predictive 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.


CONCLUSIONS
The prevalence 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 symptoms of depression and anxiety among patients in cardiac rehabilitation at Reykjalundur.
Kristjánsson
Karl
K
Reykjalundi, Endurhaefingarmidstöd, 270 Mesfellsbae. karlk@reykjalundur.is
Pórunn
Gudmundsdóttir
G
Jónasson
Magnús R
MR
D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D000072038:Cardiac Rehabilitation; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000523:psychology*; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D008297:Male; D011237:Predictive Value of Tests; D015995:Prevalence; D015397:Program Evaluation; D011569:Psychiatric Status Rating Scales; D012047:Rehabilitation Centers; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires