Branimir Čatipović

Relation between Major and Minor Depression and Heart Rate, Heart-Rate Variability, and Clinical Characteristics of Patients with Acute Coronary Syndrome

This study examined the prevalence of major and minor depression in patients with acute coronary syndrome and their relation with heart rate and heart-rate variability, and clinical characteristics. The study group included 297 patients, 200 men and 97 women, between ages of 21 and 70 years (M age = 57.5 ± 9.6), who were admitted to a coronary care unit with acute coronary syndrome and survived to discharge from the hospital. Major and minor depression were diagnosed using DSM-IV. There were 44.1% patients with acute coronary syndrome without depression, 29.3% with minor depression, and 26.6% with major depression. The prevalence of minor and major depression was more elevated in patients with non-ST-segment elevation myocardial infarction and unstable angina than in patients with ST-segment elevation myocardial infarction. Ventricular fibrillation and atrial fibrillation were more common in patients with major and minor depression than in patients without depression. The 24-hr. duration of heart-beat intervals and heart-rate variability were significantly lower in patients with major and minor depression than in patients without depression. This study implies that clinical depression was significantly comorbid with the acute coronary syndrome and was related to hypertension, diabetes mellitus, age, sex, type of acute coronary syndrome, left ventricular failure, higher heart rate, and lower heart-rate variability.

Association of Heart Rate and Heart-Rate Variability with Scores on the Emotion Profile Index in Patients with Acute Coronary Heart Disease:

We investigated the link between the eight basic emotions named by Plutchik and heart rate, heart-rate variability in the 114 patients, 86 men and 28 women (M = 53.8 yr., SD = 8.0) with acute coronary heart disease during the initial 24-hr. stay in the coronary care unit and again at hospital discharge. Variability in heart rate was significantly positively associated with scores on Trust (the emotional state acceptance) at hospital admission and discharge in the patients with unstable angina and non-Q-wave infarction, on Aggression in the patients with unstable angina at hospital discharge and at hospital admission in the patients with non-Q-wave infarction. There was inverse relation on Timid (the emotional state fear) and Gregarious (joy) at hospital admission and on Distrust (disgust or rejection), Depressed (sadness), and Dyscontrol (impulsiveness) at hospital discharge in the patients with non-Q-wave infarction. There was no significant association between heart-rate variability and the scores on the Emotion Profile Index in the patients with anterior and posterior myocardial infarction. There was no statistically significant association between heart rate and scores on the Emotion Profile Index in the patients with acute coronary disease at hospital admission and discharge. Our results suggest psychological interventions that enhance emotional states represented by the Trust and Aggression scales and minimize those represented by Depressed, Dyscontrol, Timid, and Distrust scales could have a beneficial effect on cardiovascular function in the patients with unstable angina and non-Q-wave infarction in a hospital setting.

Relationship of eight basic emotions with age, sex, education, satisfaction of life needs, and religion.

Personality scores of Croatian men and women by age, occupation, education, satisfaction of life needs, and religion were examined. 842 men and 242 women whose mean age was 42 yr. (SD, 8) represented manual labor, clerical work, and management. Employees were administered the Emotions Profile Index and a test of Life Needs Satisfaction. The Croatian women scored lower on Distrustful and Dys-control than the Croatian men and higher on Depression and Gregarious. Scores on Aggression, Depression, and Gregarious varied across age groups. The Reproduction scores of sociable and affectionate were significantly higher for managers and persons with university education. The religious employees scored higher on Depression than nonreligious persons. The Reproduction scores were significantly positively associated with all needs satisfaction scores. The Destruction scores (Aggression, Depression) were significantly negatively associated with most life needs satisfactions. The present analysis suggests men and women from Croatian groups have different personality profiles Correlations of emotional scores with ages, occupations, education, life needs satisfaction, and religion could help in modification toward positive emotional dimensions.

Type A/B Behavior and Eight Basic Emotions in 1084 Employees:

We examined the prevalence of Type A/B behavior and Emotion Profiles in 1084 employees. This report focused on the relationship between Type A behavior and eight basic emotion dimensions. Of the 1084 subjects 710 (65%) scored as Type A and 374 (34.5%) as Type B. The mean Bortner scores for all subjects were 182.8 (SD = 33.7), scores on emotional dimensions for Incorporation and Reproduction were high, and intensities for Ejection and Destruction were low; mean scores on other emotions were normal. Significant differences between Type A and Type B scores were found on six emotional dimensions. Subjects classified as Type A had ratings lower on trustful, controlled, and timid and higher on aggressive, distrustful, and uncontrolled than did persons classified as Type B. There were no differences between Type A and Type B scores on the emotion dimensions of Reproduction and Deprivation. Our data suggest multiple emotional components may comprise the Type A behavior pattern. This is important for behavioral counseling programs and early preventive efforts which could be aimed at reducing the intensity of Type A behaviors.

Association of scores for Type A behavior with age, sex, occupation, education, life needs satisfaction, smoking, and religion in 1084 employees

The associations of Type A or B behavior with age, sex, occupation, education, life needs satisfaction, smoking, and religion were studied. 242 women and 842 men, ages 21 to 64 years, (M age 42 ± 8 yr.), completed the Bortner scale and rated on a 5-point scale their life needs satisfaction. Information on age, occupation, education, cigarette smoking, and religion were obtained from each subject. Scores for Type A and Type B behavior patterns in different age groups were very similar. Scores on Type A behavior were significantly more common in women than men. Type A behavior scores were identified in a larger proportion of managers, clerks, and in persons with university education than in manual workers and persons with only primary and secondary education. There was no difference between smokers and non-smokers and religious and nonreligious scorers. There was no difference in ratings for life needs satisfaction between persons identified as having scores on Type A and Type B behavior. The present analyses enhance our understanding of Type A behavior as related to age, sex, occupation, education, and life needs satisfaction in a Croatian sample.

Heart Rate and Heart-Rate Variability in Patients with Acute Coronary Heart Disease Classified on Bortner's Scale as Type a and Type B

We investigated heart rate and heart-rate variability in 82 patients, 60 men and 22 women (M = 54 yr, SD = 9) with acute coronary heart disease and scores on Bortners scale at hospital admission and discharge. 48 patients were classified by their scores on Bortners scale as Type A and 34 as Type B. Patients with acute coronary heart disease classified as Type A had a significantly lower mean heart rate than patients with acute coronary heart disease classified as Type B during the day at hospital admission and discharge and during the night at hospital discharge. Mean heart-rate variability was also significantly higher in the patients with acute coronary heart disease classified as Type A than in the patients with acute coronary heart disease classified as Type B during the day at hospital admission and discharge. The differences between two groups on the average heart rate and heart-rate variability were not significant during the night at hospital admission. In our study the patients with acute coronary heart disease classified by scores on Bortners scale as Type A had higher vagal tone and more favorable sympathovagal balance than patients classified as Type B. This finding may have implications for the treatment of patients with acute coronary heart disease and may suggest some explanation about the protective effect of Type A behavior also.

BORTNER TYPE A SCORES AND EIGHT BASIC EMOTIONS FOR SURVIVORS OF VENTRICULAR FIBRILLATION AND LEFT VENTRICULAR FAILURE DURING ACUTE MYOCARDIAL INFARCTION

We examined Bortner scores for behavioral patterns and eight basic emotional dimensions named by Plutchik for patients with acute myocardial infarction who survived ventricular fibrillation and left ventricular failure. There were 70 patients, 48 men and 22 women ages 26 to 69 yr. (M = 54, SD = 8), admitted to the coronary care unit within 24 hours of the onset of a long-lasting chest pain. Six patients survived an episode of ventricular fibrillation that occurred within 24 to 48 hours after their admission. 15 patients developed left ventricular failure and were in Killip Classes II and III. Patients with acute myocardial infarction and left ventricular failure had mean Bortner scores significantly lower than others with acute myocardial infarction and were classed as Type B behavior. There was no difference in Bortner scores between patients with ventricular fibrillation and others with acute myocardial infarction. Patients with acute myocardial infarction and left ventricular failure scored significantly higher on Timid than others with acute myocardial infarction. Patients with acute myocardial infarction and ventricular fibrillation scored significantly lower on Depressed and higher on Distrust than other patients with acute myocardial infarction. Our findings suggest that patients with ventricular fibrillation and low scores on Depressed have good hospital prognosis. They are more critical and tend to reject people and ideas more than patients with acute myocardial infarction. This study suggests that the way in which patients with acute myocardial infarction react to their infarction, in terms of eight basic emotions and test patterns, is dependent on the complications of myocardial infarction.