PSYCHOLOGICAL, MEDICAL AND BIO-BEHAVIORAL FACTORS IN CORONARY HEART DISEASE.

The aim of this study is to emphasize the importance of an integrative bio-behavioral approach to coronary heart disease. We explored relationships between psychological characteristics and traditional biomedical risk factors of coronary heart disease, by using specific methods not commonly used in Slovakia (VCE interview, RIA serotonin levels assessment). A structured interview was conducted with 89 patients, who were divided into 4 diagnostic groups: 1) cardiac patients after myocardial infarction (MI), 2) patients suffering from metabolic syndrome, 3) patients with depression, and 4) participants with growth hormone insufficiency. The VCE interview (Friedman, Ghandour, 1993) was used to assess the levels of free-floating hostility and time urgency. Beck's questionnaires (BDI, BAI) and Zung's inventory were employed in order to explore depression and anxiety. The B.P.A.I. questionnaire was used as the measure of anger and hostility. Medical and biochemical examinations were also performed (e.g., BMI, blood pressure, Doppler, EKG, cholesterol, serotonin). ANOVA, Pearson's coefficients and factor analysis were used as the statistical methods. Cardiac patients after MI scored significantly higher in free-floating hostility, time urgency and total score of the VCE interview compared to all other groups. It has been shown that results of the VCE structured interview are efficient in distinguishing patients with coronary heart disease from patients without this disorder. Cardiac patients also had higher levels of anxiety and depression, which were significantly associated with the lowest serotonin levels in this group. The group of patients with metabolic syndrome had higher levels of the above-mentioned variables compared to the group with depression and growth hormone insufficiency, which illustrates on the psychological level that metabolic syndrome might be perceived as an antecedent of future coronary heart disease. The trend of higher cardiac risk in patients suffering from depression was also partially confirmed. The results of the present study showed that psychosocial factors, especially free-floating hostility and time urgency, are strongly connected to the somatic risk factors which play an important role in the origin and development of coronary heart disease. More attention should be paid to psychosocial factors when considering the treatment and prevention of coronary heart disease. [ABSTRACT FROM AUTHOR]