Psychosomatic Aspects of Congestive Heart Failure

Abstract

The purpose of this study was to investigate the psychosomatic correlations in CHF patients with anxiety and depressive disorders (DDs). Materials and Methods: This study involved 102 patients (60 men and 42 women) with CHF functional class (FC) II-III (NYHA) in age from 41 to 65 (mean age, 56.3±2.7). 6MWT as a sub-maximal exercise test was used to determine functional capacity in patients. Patients' subjective assessment of dyspnea was conducted using the modified VAS in the form of a 10 cm long straight line. The personality characteristics were studied using the FPI. DDs were assessed by HAM-A and HAM-D. The average score of DD severity in the general group of patients was 11.36±2.24 points, which corresponds to a moderate depressive episode, according to HAM-D. Data analysis revealed that the degree of DDs in the examined patients was a direct function of CHF severity. The severity of dyspnea was associated not only with the clinical-instrumental characteristics of CHF (LVEF, 6MWT), but also with the personality and the behavioral and psychological peculiarities of the patients: smoking, hypochondriac type of attitude towards the disease, sleep disorders, severity of depression and anxiety. Conclusion: The obtained data demonstrate that mental disorders observed in CHF patients aggravate the severity of the patients’ condition and decrease their adaptive capability, thus adversely affecting the course and outcome of the underlying disease.

Keywords

• anxiety;
• depression
• congestive heart failure
• psychosomatic disorders