Study of Phobic Manifestations and Anxiety in Patients with Coronary Heart Disease after Myocardial Infarction in View of Tasks of Psychological Rehabilitation
- Authors: Velikanov A.A.1, Boyarskaya A.A.2, Stoljarova A.A.1, Protasov E.A.1, Lubinskaya E.I.1, Demchenko E.A.1
-
Affiliations:
- Almazov National Medical Research Centre
- Pavlov First Saint Petersburg State Medical University
- Issue: Vol 16, No 4 (2019)
- Pages: 517-539
- Section: PSYCHOPHYSIOLOGY AND CLINICAL PSYCHOLOGY
- URL: https://journals.rudn.ru/psychology-pedagogics/article/view/22807
- DOI: https://doi.org/10.22363/2313-1683-2019-16-4-517-539
Cite item
Full Text
Abstract
The study of the psycho-emotional features of patients with coronary heart disease (CHD) is important for the development of psychological rehabilitation measures. In particular, it is necessary to take into account the specifics of the experienced fears and anxiety states which can be manifested in patients after myocardial infarction (MI). Negative psycho-emotional experiences are known to influence the course and prognosis of the disease. Identification of the structure of phobic manifestations, anxiety and personal characteristics of patients is appropriate for optimizing psychodiagnostics and psychocorrection. The present research is aimed at studying the characteristics of phobic manifestations and the structure of anxiety in patients with coronary heart disease (CHD) after myocardial infarction (MI), considering the dominant state, indicators of quality of life and personal characteristics. In the course of the present study 67 patients were surveyed with gender distribution of 12 women (18%) and 55 men (82%): patients of the Almazov National Medical Research Centre of the Ministry of Health of the Russian Federation who had a history of myocardial infarction (up to 1 year) and had undergone myocardial revascularization. The average age of the patients was 58.95 years. Clinical interview and psychological testing (Dominant State Determining Method, Integrative Test of Anxiety, The 36-Item Short Form Health Survey (SF-36), The Big Five Personality Test) were used. In patients with CHD after MI with substantial fears the most frequently detected phobic manifestations are the fear of physical activity and the fears associated with the disease itself. In the group of patients with the presence of phobic manifestations more pronounced indicators of anxiety, lower indicators of quality of life (QoL) and emotional stability in the structure of personal characteristics were noted. When planning psychological rehabilitation for patients with CHD who have undergone MI, it is important to consider the likelihood of anxiety and phobic manifestations.
About the authors
Arseniy A. Velikanov
Almazov National Medical Research Centre
Author for correspondence.
Email: arsen.velikanov@gmail.com
Ph.D. in Psychology, Associate Professor, is Associate Professor of Human Sciences Department, Clinical Psychologist of the Psychotherapy Department
2 Akkuratova St., Saint Petersburg, 197341, Russian FederationAnna A. Boyarskaya
Pavlov First Saint Petersburg State Medical University
Email: anna.boyarskaya@gmail.com
assistant of General and Clinical Psychology Department
6-8 Lva Tolstogo St., Saint Petersburg, 197022, Russian FederationAnna A. Stoljarova
Almazov National Medical Research Centre
Email: anna.stoljarova@gmail.com
psychologist, volunteer
2 Akkuratova St., Saint Petersburg, 197341, Russian FederationEvgeniy A. Protasov
Almazov National Medical Research Centre
Email: akkuratova2@gmail.com
physiotherapist
2 Akkuratova St., Saint Petersburg, 197341, Russian FederationEkaterina I. Lubinskaya
Almazov National Medical Research Centre
Email: lubinskaya1@bk.ru
Ph.D. in Medicine, cardiologist, is Senior Researcher of the Research Laboratory of Rehabilitation
2 Akkuratova St., Saint Petersburg, 197341, Russian FederationElena A. Demchenko
Almazov National Medical Research Centre
Email: elenademchenko2006@rambler.ru
M.D., is head of the Research Laboratory of Rehabilitation
2 Akkuratova St., Saint Petersburg, 197341, Russian FederationReferences
- Akimova, E.V., Gakova, E.I., Kayumova, M.M., Zagorodnykh, E.Y., Kayumov, R.K., Smaznov, V.Y., Gafarov, V.V., & Kuznetsov, V.A. (2015). Anxiety, coronary heart disease and metabolic syndrome in male population: prevalence and interrelations. Arterialnaya Gipertenziya, 21(2), 138–144. https://doi.org/10.18705/1607-419X-2015-21-2-138-144 (In Russ.)
- Batelaan, N.M., Seldenrijk, A., Bot, M., van Balkom, A.J., & Penninx, B.W. (2016). Anxiety and new onset of cardiovascular disease: critical review and meta-analysis. British Journal of Psychiatry, 208(3), 223–231. https://doi.org/10.1192/bjp.bp.114.156554
- Belan, I.A., Lozhnikova, L.E., & Barbukhatti, K.O. (2015). Anxiety influence on coronary heart disease course after bypass grafting. Kardiosomatica, (S1), 9–10. (In Russ.)
- Belyalov, F.I. (2017). Depression, anxiety and stress in patients with coronary heart disease. Therapeutic Archive, 89(8), 104–109. https://doi.org/10.17116/terarkh2017898104-109 (In Russ.)
- Bereznyak, J.S., & Seleznev, S.B. (2017). Clinical and psychological features of patients with coronary heart disease. Siberian Medical Journal, 32(1), 87–91. https://doi. org/10.29001/2073-8552-2017-32-1-87-91 (In Russ.)
- Bizyuk, A.P., Wasserman, L.I., & Iovlev, B.V. (2005). The Application of the Integrative Test of Anxiety: Methodic Recommendations. Saint Petersburg: NIPNI imeni V.M. Bekhtereva Publ. (In Russ.)
- Bolotova, E.V., & Komissarova, I.M. (2017). Gender and age associations of cardiovascular risk factors in patients with coronary heart disease. Profilakticheskaya Meditsina, 20(6), 68–75. https://doi.org/10.17116/profmed201720668-75 (In Russ.)
- Chauvet-Gelinier, J/.C., & Bonin, B. (2017). Stress, anxiety and depression in heart disease patients: A major challenge for cardiac rehabilitation. Annals of Physical and Rehabilitation Medicine, 60(1), 6–12. https://doi.org/10.1016/j.rehab.2016.09.002
- Cherkasova, V.L., & Lyakhova, O.L. (2016). Opredelenie ponyatiya “trevozhnost’ ” i prichiny ee vozniknoveniya. Aktual’nye problemy estestvennonauchnogo obrazovaniya, zashchity okruzhayushchei sredy i zdorov’ya cheloveka, 2(2), 411–415. (In Russ.)
- De Hert, M., Detraux, J., & Vancampfort, D. (2018). The intriguing relationship between coronary heart disease and mental disorders. Dialogues in Clinical Neuroscience, 20(1), 31–40.
- Emdin, C.A., Odutayo, A., Wong, C.X., Tran, J., Hsiao, A.J., & Hunn, B.H. (2016). Meta-Analysis of Anxiety as a Risk Factor for Cardiovascular Disease. American Journal of Cardiology, 118(4), 511–519. https://doi.org/10.1016/j.amjcard.2016.05.041
- Grazhdan, I.K., Kopylov, F.Yu., Aksenova, M.G., Barskiy, V.I., & Kirillov, A.V. (2015). Pathogenetic relationship between personality traits and mental derangement with coronary heart disease. Kardiologia i Serdechno-Sosudistaya Khirurgia, (2), 8–20. https://doi. org/10.17116/kardio2015828-20 (In Russ.)
- Ivanov, M.S., Solodukhin, A.V., Pomeshkina, S.A., Seryy, A.V., Yanitskiy, M.S., & Gorbunova, E.V. (2018). Worries and Fears in the System of Attitudes to Personal Security of Patients with Cardiovascular Diseases. RUDN Journal of Psychology and Pedagogics, 15(4), 458–472. http://dx.doi.org/10.22363/2313-1683-2018-15-4-458-472 (In Russ.)
- Kovpak, D.V. (2012). Strakhi, trevogi, fobii… Kak ot nikh izbavit’tsa? Moscow: Nauka i tekhnika Publ. (In Russ.)
- Kulikov, L.V. (2003). A Guide to the Methods of Diagnosing Mental States, Moods, and Feelings. Description of Techniques and Instructions for Use. Saint Petersburg: SPGU Publ. (In Russ.)
- Latfullin, I.A. (2017). Ishemicheskaya Bolezn’ Serdca: Osnovnye Factory Riska, Lechenie. Kazan: Kazan University Publ. (In Russ.)
- Lysova, T.A., Enikolopov, S.N., Volel, B.A., & Syrkina, E.A. (2015). Psychological structure of neurotic hypochondria in coronary heart disease. Psihicheskie Rasstroystva v Obschey Meditsine, (2–3), 21–30. (In Russ.)
- Meshcheryakov, B.G., & Zinchenko, V.P. (Eds.). (2009). A Significant Psychological Dictionary. Moscow: AST Publ.; Saint Petersburg: Praym-Evroznak Publ. (In Russ.)
- Mychaіlovskaya, N.S., Litvinenko, V.A., & Melnik, A.I. (2015). Relationship of the anxietydepressive disorder with coronary heart disease, comorbid with metabolic syndrome. Zaporozhye Medical Journal, (5), 23–27. https://doi.org/10.14739/2310-1210.2015.5.53743 (In Russ.)
- Nikulina, I.V., Trushkina, V.V., Nedbaikin, A.M., Yusova, I.A., & Bessonova, I.A. (2017). Vyyavlenie i korrektsiya patologicheskikh emocional’nykh reakcii u trudosposobnykh patsientov s IBS na etape reabilitatsii. Cardiosomatika, 8(1), 61–62. (In Russ.)
- Obrezan, A.G., & Kulikov, N.V. (2018). Evaluation of the behavioral risk factors for coronary heart disease (review). Medicinskij Alyans, (1), 84–88. (In Russ.)
- Ovchinnikov, A.A., Sultanova, A.N., Kovalenko, A.A., & Sycheva, T.Y. (2018). Resilience and stress coping techniques in patients with ischemic heart disease. Journal of Siberian Medical Sciences, (2), 72–77. (In Russ.)
- Pedersen, S.S., von Känel, R., Tully, P.J., & Denollet, J. (2017). Psychosocial perspectives in cardiovascular disease. European Journal of Preventive Cardiology, 24(3_suppl), 108–115. https://doi.org/10.1177/2047487317703827
- Pogosova, N., Kotseva, K., De Bacquer, D., von Känel, R., De Smedt, D., Bruthans, J., & Dolzhenko, M. (2017). Psychosocial risk factors in relation to other cardiovascular risk factors in coronary heart disease: Results from the EUROASPIRE IV survey. A registry from the European Society of Cardiology. European Journal of Preventive Cardiology, 24(13), 1371–1380. https://doi.org/10.1177/2047487317711334
- Ponomarenko, G.N. (2016). Physical and Rehabilitation Medicine: National Guideline. Moscow: GEOTAR-Media Publ. (In Russ.)
- Prokhorenko, I.O., Zarubina, E.G., Sergeev, O.S., & Suhachev, P.A. (2016). Influence of psychological personality traits of elderly patients on the incidence, severity and dynamics of coronary heart disease. Vestnik Meditsinskogo Instituta “REAVIZ”: Reabilitatsiya, Vrach i Zdorove, 3(23), 50–59 (In Russ.)
- Pushkarev, G.S., Kuznetsov, V.A., Yaroslavskaya, E.I., & Bessonov, I.S. (2017). Prognostic Significance of Psychosocial Risk Factors in Patients With Ischemic Heart Disease After Percutaneous Coronary Interventions. Kardiologiia, 57(6), 11–15. https://doi. org/10.18565/cardio.2017.6.11-15 (In Russ.)
- Reber, A. (2003). The Oxford Dictionary of Psychology (vol. 1). Moscow: Veche Publ., AST Publ. (In Russ.)
- Selivanova, G.B. (2017). Comorbid patient in the internal medicine: cardiovascular diseases and anxiety. Cardiovascular Therapy and Prevention, 16(5), 76–80. https://doi. org/10.15829/1728-8800-2017-5-76-80 (In Russ.)
- Sirotа, N.A., & Moskovchenko, D.V. (2015). Fear of disease progression and coping behaviors in patients with coronary heart disease. V.M. Bekhterev Review of Psychiatry and Medical Psychology, (4), 87–94. (In Russ.)
- Solodukhin, A.V., Seryi, A.V., Yanitskiy, M.S., & Trubnikova, O.A. (2017). Cognitive behavioral therapy: an option for changing internal picture of disease in patients with coronary artery disease. Fundamental’naja i Klinicheskaja Medicina, 2(1), 84–90. https:// doi.org/10.23946/2500-0764-2017-2-1-84-90 (In Russ.)
- Vasserman, L.I., & Shchelkova, O.Yu. (2003). Medical Psychodiagnostics: Theory, Practice And Training. Saint Petersburg: Saint Petersburg University Press; Moscow: Akademiya. (In Russ.)
- Yanichev, D.P. (2006). Cognitive Aspects of Self-Perception of Personality Traits in Patients with Neurotic and Neurosis Symptoms. Ph.D. in Psychology Thesis. Saint Petersburg: Saint Petersburg State University. (In Russ.)