Severity of psychological distress over five years differs as a function of sex and presence of coronary artery disease

Abstract

Background

Psychological distress is more prevalent and severe among patients with coronary artery disease (CAD) compared to healthy individuals. Little is known regarding its time course, and whether these differences extend to individuals with non-cardiovascular (CV) illnesses. This study examined the presence, severity, and time course of psychological distress in men and women with CAD and those of similarly aged individuals suffering from non-CV conditions.

Methods

1229 individuals (61% men; mean_age = 60.4 ± 7.0 years) with stable CAD or non-CV illnesses reported on social support, hostility, stress, anxiety and depression at baseline as well as 4.8 ± 0.8 years later. Analyses involved mixed (Sex*CAD status*Time) repeated measures analyses (controlling for relevant covariates), as well as Chi-square and McNemar analyses.

Results

Women with CAD reported more symptoms of depression compared to other participants at both evaluations (p’s < 0.01), and reported more symptoms of anxiety and stress compared to others at T1 (p’s < 0.05). At T2, perceived stress remained significantly greater among women with CAD compared to men (p’s < 0.01), though differences in anxiety were no longer significant. Men reported more hostility than women (p = 0.001). CAD women fell within the clinical range for depression (p < 0.001), anxiety (p = 0.001), and stress (p = 0.030) more frequently compared to others at T1, and for depression (p = 0.009) and stress (p = 0.002) at T2.

Conclusions

The evolution of patient distress differed as a function of the measure examined, their sex, and/or CV status. While psychological distress was prevalent among these patients with diverse health conditions, women with CAD were particularly and chronically vulnerable.

Keywords:

• Psychological distress
• coronary artery disease
• depressive symptoms
• anxiety symptoms
• stress symptoms
• chronic illness

Acknowledgements

The authors are grateful to the participants and staff of the André and France Desmarais Hospital Cohort of the Montreal Heart Institute for their contribution to the study, as well as the volunteers and research assistants of the Heart and Mind Research Unit in Behavioural and Complementary Medicine. Sincere thanks as well to the Canadian Institutes of Health Research and the Ordre Fraternal des Aigles 3176 Inc (St-Jérome) for funding this project.

Disclosures statement

The authors report no conflicts of interest.

Additional information

Funding

This research was supported by grants awarded to Dr Bianca D’Antono by the Canadian Institutes of Health Research (CIHR; MOP # 111015) and a dedicated donation to Bianca D’Antono by Ordre Fraternal des Aigles 3176 Inc (St-Jérome).