[Complex evaluation in correction of mental disorders in patients with coronary artery disease]

Borderline mental disorders and affective disturbances of the actual mental status of patients with coronary artery disease (CAD) were studied; they were corrected with cognitive psychotherapy. The subjects of the study were 107 patients with a validated CAD diagnosis (FK I to III stenocardia) and chronic heart failure (CHF) syndrome, and 78 patients suffering from CAD without CHF. Mental disorders were diagnosed in accordance to International Classification of Diseases-10. Borderline mental disorders in CAD patients chiefly consisted in adaptation disorders (46.8%), dysthymia (16%), neurotic disorders (13.8%), and organic mental disorders (23.4%). The listed disorders in most cases occur as a result of stress, which, according to the study, is caused mainly by cardiac pathology; although these disorders are superficial and polymorphic, they play a significant role in the psychosomatic mechanism of the occurrence and deterioration of CAD. The occurrence of heart failure facilitates the growth of depressive affect in CAD patients (75.7% of CHF patients vs. 42.3% of patients without CHF), which is usually accompanied by anxiety disorder. Correction of psychological orientation and reduction of involvement in the problem, as well as disease education during a 3-week course led to more than a two-fold reduction in the level of depression and anxiety.