title: The scores of Hamilton depression, anxiety, and panic agoraphobia rating scales in patients with acute coronary syndrome.
abstract: OBJECTIVE
  Psychological factors may influence the development and prognosis of coronary heart disease. The purpose of this study was to measure levels of depression, anxiety, and panic agoraphobia in patients who had been treated for acute coronary syndrome (ACS). We attempted to evaluate the relationship of the scores of depression, anxiety and panic agoraphobia, coronary risk factors, some clinical variables and coronary heart disease.
  
  
  METHODS
  We evaluated the levels of depression, anxiety, and panic agoraphobia of patients who had been treated for ACS, using the Hamilton depression (HAM-D), the Hamilton anxiety (HAM-A), and the Hamilton panic agoraphobia (HAM-PA) rating scales in 82 patients underwent treatment for acute coronary syndrome in this cross-sectional observational study. The relationship of these psychological variables with gender, presence of diabetes mellitus, hypercholesterolemia and coronary revascularization were assessed. Statistical analysis was performed using unpaired t test for independent samples and Chi-square test.
  
  
  RESULTS
  The majority of the patients were male (54 males and 28 females); the mean age of the patients was 61.9 +/- 12.1 years; 46% were admitted for unstable angina, 37.8% for acute myocardial infarction (MI) with ST elevation, and 16.7% with non-ST-elevation MI. Depressive symptoms (HAM-D score>8) were present in 87.8% of the patients. The HAM-D score was closely related to the HAM-A and the HAM-PA scores (p<0.001). The HAM-D, HAM-A, and HAM-PA scores were significantly higher in female patients (p<0.001). After controlling for sex, both the HAM-D score (21.05 +/- 7.72 vs 15.10 +/- 7.3; p=0.02) and the HAM-A score (19.17 +/- 9.50 vs 12.96 +/- 7.77; p=0.03) were significantly higher in diabetic patients. The mean HAM-D score was also significantly higher in patients with hypercholesterolemia (18.10 +/- 8.23 vs 13.97 +/- 6.38; p=0.02), as well as in those with a previous history of cerebrovascular disease (CVD) (23.20 +/- 9.62 vs 15.89 +/- 7.45; p=0.02). Patients who had undergone coronary artery bypass grafting (CABG) showed significantly lower HAM-D (12.5 +/- 7.8 vs 16.6 +/- 8.1; p=0.03) and HAM-A (9.6 +/- 6.3 vs 15.6 +/- 8.5; p=0.01) scores.
  
  
  CONCLUSIONS
  Higher scores of depression, anxiety, and panic agoraphobia were particularly common findings in female patients and in those patients with diabetes mellitus, hypercholesterolemia, and CVD. Depression and anxiety disorder may be prevalent in patients who had been treated for ACS. We believe that patients should be carefully followed and treated for depression and anxiety disorder after ACS treatment to prevent adverse outcomes.
authors.affiliation: Clinic of Cardiology, Kirşehir State Hospital, Kirşehir, Turkey. mutluvural74@mynet.com
authors.forename: Mutlu
authors.initials: M
authors.lastname: Vural
authors.forename: Mehmet
authors.initials: M
authors.lastname: Acer
authors.forename: Berfu
authors.initials: B
authors.lastname: Akbaş
mesh_terms: D000379:Agoraphobia / Q000150:complications / Q000523:psychology; D001008:Anxiety Disorders / Q000150:complications / Q000523:psychology; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D003920:Diabetes Mellitus / Q000523:psychology; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000523:psychology*; D016584:Panic Disorder / Q000150:complications / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D014421:Turkey / Q000453:epidemiology