PSYCHIATRIC MORBIDITY IN PATIENTS OF MYOCARDIAL INFARCTION

Abstract

Objective: To determine the proportion of anxiety, depression
and cognitive impairment in patients of acute myocardial infarction during early recovery phase, to emphasize
the significance of increase in cardiac mortality in such patients and to stress the need for prevention and early
treatment of psychiatric co-morbidity. Design: It was a cross-sectional study. Place and Duration of Study:
The study was carried out at the Armed Forces Institute of Cardiology and National Institute of Heart Diseases
(AFIC&NIHD) Rawalpindi, from 1st November 2002 to 30th February 2003. Materials and Methods: One
hundred consecutive cases of acute myocardial infarction admitted to AFIC & NIHD were included in the
study. Details were recorded in the proforma designed for this purpose. Urdu versions of Hospital Depression
and Anxiety Scale (HADS) and Mini Mental State Examination (MMSE) were used to pick up the psychiatric
morbidity. Data analysis was carried out by the computer software programme “Biostats”. Results: 18 patients
were found to have psychiatric morbidity. 10 out of these had anxiety, 6 depression and 2 cognitive impairment.
Age range was between 33 and 75 years with mean age 50.66 years. All index cases had ‘Q’ wave type of
infarction. 10 patients had anterior MI, 5 inferior MI and 3 had antero-lateral infarction. 14 patients had recent
stressful life events. Conclusion: Acute MI carries major stress in a person’s life and it has its psychological
consequences as well. Definite psychological morbidity exists in the recovery phase of acute MI and it includes
anxiety as the commonest form of disorder, followed by depression and cognitive impairment.