Comprehensive rehabilitation of patients with coronary heart disease concurrent with anxiety and depression disorders

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Abstract

In cardiological inpatients, coronary heart disease (CHD) is concurrent with clinical anxiety and depression disorders in 43% of cases. Comorbidity of coronary disease and anxiety and depression disorders is more frequently encountered among women than among men (40 versus 22%) and among post-aortocoronary bypass patients. Depressive disorders substantially worsen the course of CHD due to the frequent development of myocardial infarction, low exercise endurance, and patients’ refusal to have endovascular and surgical treatments. Therapy with selective serotonin reuptake inhibitor (SSRI) antidepressants caused a reduction in anxiety and depression disorders along with the improved clinical course of CHD, as evidenced from angina pectoris and heart failure. No serious side effects were observed during continuous SSRI use. The proposed regimen for the joint follow-up, treatment, and rehabilitation of patients by a working group of cardiologists and psychiatrists within a biopsychosocial model of rehabilitation is effective. It may be extensively used in cardiology, in the outpatient setting in particular.

About the authors

A. N Repin

Cardiology Research Institute, Siberian Branch, Russian Academy of Medical Sciences

Email: ran@cardio.tsu.ru; ran_12@mail.ru
д-р мед. наук, проф., рук. отд. реабилитации

E. V Lebedeva

Research Institute of Mental Health, Siberian Branch, Russian Academy of Medical Sciences, Tomsk

Email: lebedevaev@sibmail.com
канд. мед. наук, ст. науч. сотр. отд. аффективных состояний

T. N Sergienko

Cardiology Research Institute, Siberian Branch, Russian Academy of Medical Sciences

Email: orb3@cardio.tsu.ru
канд. мед. наук, науч. сотр. отд. реабилитации

R. S Karpov

Cardiology Research Institute, Siberian Branch, Russian Academy of Medical Sciences

Email: ran@cardio.tsu.ru; ran_12@mail.ru
д-р мед. наук, проф., рук. отд. реабилитации

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