Authors

• Dubravka Kruhek — Institute for Cardiovascular Prevention and Rehabilitation, Zagreb, Croatia
• Leontić — Institute for Cardiovascular Prevention and Rehabilitation, Zagreb, Croatia — ORCID: 0000-0001-7899-2044
• Mario Ivanuša — Institute for Cardiovascular Prevention and Rehabilitation, Zagreb, Croatia — ORCID: 0000-0002-6426-6831

Keywords

depression, anxiety, cardiovascular rehabilitation

DOI

Full Text

In the last few decades, the awareness of the impact of the psychological functioning on the cardiovascular (CV) system has been rising. Science has first recognized the negative effects of stress followed by other psychological factors. Recently, attention has been focused on the negative impact of depression and anxiety on the development of CV disease and the prognosis of patients after CV incident. Accordingly, many countries and global organizations have recognized the need for a comprehensive CV rehabilitation. Modern rehabilitation of CV patients should therefore involve well-educated interdisciplinary team that will, among other things, provide patients high quality psychosocial care. (1) Various scientific sources suggest that 11-25% of patients with coronary heart disease develop clinically significant depression, and about 30% have a mild depressive disorder. 10-50% CV patients develop clinically significant anxiety. The problem concerning the psychological risk factors is even greater with respect to the results of research on sub-diagnostics and failure to treat mental diseases and disorders in CV patients. Institute for Cardiovascular Prevention and Rehabilitation has in the last two years in its outpatient cardiac rehabilitation program, along with standard psychological care (2), taken steps for early detection of psychological risk factors and the overall management of patients with severe mental disorders. Thus, all patients are at the time of enrollment subject to screening for anxiety and depression by using Hospital Anxiety and Depression scale (3). In addition to a psychologist working for the Institute, the team is also joined by permanent associate - a psychiatrist from the Psychiatric Hospital “Sv. Ivan”. For patients who are assumed to need additional workup and permanent treatment, care is provided in the Referral Centre of the Ministry of Health for Disorders Caused by Stress, in the University Hospital Dubrava. In this way, the care of psychological risk factors has been completed and the element for effective CV rehabilitation has been added.

Literature

1. Pogosova N, Saner H, Pedersen SS, Cupples ME, McGee H, Höfer S, et al. Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation of the European Society of Cardiology. Psychosocial aspects in cardiac rehabilitation: From theory to practice. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation of the European Society of Cardiology. Eur J Prev Cardiol. 2015;22(10):1290–306. https://doi.org/10.1177/2047487314543075
2. Ivanuša M, Narančić Skorić K, Glavaš Vražić S, Kruhek Leontić D, Heinrich M, Mažuran Brkljačić L, et al. Outpatient Cardiovascular Rehabilitation in Croatia. Cardiol Croat. 2015;10(1-2):28–42. https://doi.org/10.15836/ccar.2015.28
3. Snaith RP. The Hospital Anxiety And Depression Scale. Health Qual Life Outcomes. 2003 Aug 1;1:29. https://doi.org/10.1186/1477-7525-1-29