Copyright © 2004 by the European Society of Cardiology.
Clinical research
Distinct psychosocial differences between women with coronary heart disease and cardiac syndrome X
a Department of Cardiac Medicine, National Heart and Lung Institute, Imperial College London, Dovehouse Street, London SW3 6LY, UK
b University Department of Psychiatry, Rawnsley Building, Manchester Royal Infirmary, Oxford Road, Manchester, UK
Received December 10, 2003; revised July 14, 2004; accepted July 27, 2004 * Corresponding author. Tel.: +44 20 7351 8860/20 7532 8121; fax: +44 20 7823 3392 (E-mail: e.asbury{at}ic.ac.uk).
See page 1672 for the editorial comment on this article (doi:10.1016/j.ehj.2004.06.008)
AIMS: To compare the impact of oestrogen, gynaecological history, social support, life events and family history of CHD on psychosocial morbidity in syndrome X, CHD patients and healthy controls.
METHODS AND RESULTS: 100 female syndrome X (60±9 years), 100 female CHD (65±9 years) and 100 healthy female volunteers (61±10 years) completed the hospital anxiety and depression scale (HADS), health anxiety questionnaire (HAQ), a demographic information scale, life events scale, family history of CHD, menopausal, menstrual and gynaecological history. A 17β-oestradiol sample was taken. Syndrome X patients had higher levels of life interference (p<0.05) and HADS anxiety (p<0.05) than CHD patients, and higher levels of all HADS and HAQ scales than controls (p<0.01). Syndrome X patients with a large social network had lower HADS anxiety (p<0.05), health worry (p<0.05), life interference (p<0.01) and total HAQ (p<0.01). Social network (p=0.003), divorced/separated or widowed status (p=0.005), HRT (p=0.008) and HADS anxiety score (p<0.001) accounted for 41.9% of the variance in HAQ scores in syndrome X. Oestrogen was unrelated to the HADS or HAQ for any group.
CONCLUSION: Syndrome X patients suffered higher levels of psychological morbidity in comparison to CHD patients and controls. Life events and social network size were related to health anxiety, general anxiety and depression in women with syndrome X.
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