Clinical description of affective disorders and efficiency of antidepressant therapy

Objective: to identify the structure and clinical features of affective disorders (AD) and efficiency of antidepressants in in-patients with chronic coronary artery disease (ChCAD), living in Tomsk and the Tomsk Region.Materials and мethods. At a heart center, 1,131 patients with ChCAD were examined...

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Main Authors: E. V. Lebedeva, E. D. Schastnyy, G. G. Simutkin, A. N. Repin, T. G. Nonka
Format: Article
Language:English
Published: Siberian State Medical University (Tomsk) 2018-12-01
Series:Бюллетень сибирской медицины
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Online Access:https://bulletin.ssmu.ru/jour/article/view/1981
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author E. V. Lebedeva
E. D. Schastnyy
G. G. Simutkin
A. N. Repin
T. G. Nonka
author_facet E. V. Lebedeva
E. D. Schastnyy
G. G. Simutkin
A. N. Repin
T. G. Nonka
author_sort E. V. Lebedeva
collection DOAJ
description Objective: to identify the structure and clinical features of affective disorders (AD) and efficiency of antidepressants in in-patients with chronic coronary artery disease (ChCAD), living in Tomsk and the Tomsk Region.Materials and мethods. At a heart center, 1,131 patients with ChCAD were examined: in 290 persons (25.6%) AD were revealed, among them 72.1% were men (n = 209) and 27.9% were women (n = 81). Mean age of women was (63.5 ± 9.4) years and in men (57.9 ± 7.2) years (р = 0.004). AD structure, main syndromes, severity of depression and anxiety according to data of self-questionnaires and clinical scales before and after antidepressant therapy (predominantly with selective serotonin reuptake inhibitors (SSRI)) were studied. Comparative analysis of clinical indices of CAD respective from AD, presence of antidepressant therapy and its efficiency was performed.Results. Chronic AD were found in 45% of patients. Newly diagnosed depressive episodes made up 24.5% and recurrent depressive disorder (RDD) was 24%. 6.5% were bipolar affective disorders (BAD), predominantly bipolar II disorders. Depressive syndrome in 91.7% of patients had the second significant component (more frequently 54.8%). Characteristic of the clinical picture was dominance of complaints of bodily discomfort and pain, anergy and anhedonia. Moderate mental disturbances made up 49.0% (CGI). AD manifested at the age of 48 (40–55) years and preceded development of ChCAD. Natural course of AD was observed in 52.4% of cases. 47.6% (138/290) of patients received antidepressants, and only in 42% (58/138) clinically significant improvement was noted (more than 50% according to CGI). It was difficult to encourage patient adherence to long-term therapy (30–50% according to CGI). Physical activity tolerance (PAT) according to data of veloergometry increased in responders. Psychopharmaco- and psychotherapy should be included into rehabilitative programs for patients with ChCAD and AD.
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spelling doaj-art-d06598a24a274edda4bb9918e4173ff42025-08-20T03:02:06ZengSiberian State Medical University (Tomsk)Бюллетень сибирской медицины1682-03631819-36842018-12-01174859310.20538/1682-0363-2018-4-85-931454Clinical description of affective disorders and efficiency of antidepressant therapyE. V. Lebedeva0E. D. Schastnyy1G. G. Simutkin2A. N. Repin3T. G. Nonka4Mental Health Research Institute, Tomsk National Research Medical Center (TNRMC) of Russian Academy Sciences (RAS); Cardiology Research Institute, Tomsk National Research Medical Center (TNRMC) of Russian Academy Sciences (RAS)Mental Health Research Institute, Tomsk National Research Medical Center (TNRMC) of Russian Academy Sciences (RAS)Mental Health Research Institute, Tomsk National Research Medical Center (TNRMC) of Russian Academy Sciences (RAS)Cardiology Research Institute, Tomsk National Research Medical Center (TNRMC) of Russian Academy Sciences (RAS)Cardiology Research Institute, Tomsk National Research Medical Center (TNRMC) of Russian Academy Sciences (RAS)Objective: to identify the structure and clinical features of affective disorders (AD) and efficiency of antidepressants in in-patients with chronic coronary artery disease (ChCAD), living in Tomsk and the Tomsk Region.Materials and мethods. At a heart center, 1,131 patients with ChCAD were examined: in 290 persons (25.6%) AD were revealed, among them 72.1% were men (n = 209) and 27.9% were women (n = 81). Mean age of women was (63.5 ± 9.4) years and in men (57.9 ± 7.2) years (р = 0.004). AD structure, main syndromes, severity of depression and anxiety according to data of self-questionnaires and clinical scales before and after antidepressant therapy (predominantly with selective serotonin reuptake inhibitors (SSRI)) were studied. Comparative analysis of clinical indices of CAD respective from AD, presence of antidepressant therapy and its efficiency was performed.Results. Chronic AD were found in 45% of patients. Newly diagnosed depressive episodes made up 24.5% and recurrent depressive disorder (RDD) was 24%. 6.5% were bipolar affective disorders (BAD), predominantly bipolar II disorders. Depressive syndrome in 91.7% of patients had the second significant component (more frequently 54.8%). Characteristic of the clinical picture was dominance of complaints of bodily discomfort and pain, anergy and anhedonia. Moderate mental disturbances made up 49.0% (CGI). AD manifested at the age of 48 (40–55) years and preceded development of ChCAD. Natural course of AD was observed in 52.4% of cases. 47.6% (138/290) of patients received antidepressants, and only in 42% (58/138) clinically significant improvement was noted (more than 50% according to CGI). It was difficult to encourage patient adherence to long-term therapy (30–50% according to CGI). Physical activity tolerance (PAT) according to data of veloergometry increased in responders. Psychopharmaco- and psychotherapy should be included into rehabilitative programs for patients with ChCAD and AD.https://bulletin.ssmu.ru/jour/article/view/1981comorbidityselective serotonin reuptake inhibitorexercise tolerance
spellingShingle E. V. Lebedeva
E. D. Schastnyy
G. G. Simutkin
A. N. Repin
T. G. Nonka
Clinical description of affective disorders and efficiency of antidepressant therapy
Бюллетень сибирской медицины
comorbidity
selective serotonin reuptake inhibitor
exercise tolerance
title Clinical description of affective disorders and efficiency of antidepressant therapy
title_full Clinical description of affective disorders and efficiency of antidepressant therapy
title_fullStr Clinical description of affective disorders and efficiency of antidepressant therapy
title_full_unstemmed Clinical description of affective disorders and efficiency of antidepressant therapy
title_short Clinical description of affective disorders and efficiency of antidepressant therapy
title_sort clinical description of affective disorders and efficiency of antidepressant therapy
topic comorbidity
selective serotonin reuptake inhibitor
exercise tolerance
url https://bulletin.ssmu.ru/jour/article/view/1981
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AT anrepin clinicaldescriptionofaffectivedisordersandefficiencyofantidepressanttherapy
AT tgnonka clinicaldescriptionofaffectivedisordersandefficiencyofantidepressanttherapy