Katija Čatipović-Veselica

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.

Emotion Profiles and Quality‐of‐Life of Paced Patients

More than any other organ of human anatomy, the heart is symbolically charged with emotions. Introducing a foreign body into the heart, even a pacemaker, would be expected to alter, if not damage the most intimate of personal attributes, an individuals personality. Nevertheless, standard measures of emotions, administered before and after pacemaker implantation, revealed an improvement in psychological well‐being in an unselected sample of 80 patients, aged 36 to 80 years. Furthermore, these results occurred whether or not patients returned to work.

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.

Responses to Bortner's scale and the eight basic emotions by patients with acute coronary heart disease at hospital admission and discharge

We examined the prevalence of Type A behavior indicated on Bonners scale and the Emotion Profiles of Plutchik in 190 patients, 134 men and 56 women (M age = 50 yr., SD = 9) with acute coronary heart disease at hospital admission and discharge. Type A classification was significantly more common for patients with acute coronary heart disease (75.5% versus 65%) than for the control group. Pa-dents with acute coronary heart disease scored lower on Distrust and Dyscontrolled than the control group. Patients with unstable angina had significantly higher mean scores on Bortners scale than patients with acute myocardial infarction and recurrent myocardial infarction at hospital discharge. Patients with recurrent myocardial infarction scored lower on Distrust and higher on Timid than patients with unstable angina at hospital admission and discharge. This research suggests that Type A behavior and some emotions are associated with acute coronary heart disease. There was a difference in scores on the Emotions Profiles and scores on Type A behavior in relation to type of acute coronary heart disease. The addition of counseling for Type A behavior to standard cardiac counseling was suggested for reduction in scores on Type A behavior.

DEPRESSION IN ACUTE CORONARY SYNDROME

This study examined the prevalence of depression based on scores of 200 patients with acute coronary syndrome on the Emotion Profile Index of Plutchik and its relationship with the type of acute coronary syndrome and the severity of ischemic heart disease. Patients with acute coronary syndrome scored higher on depression than the control group. There was no difference in scores on Depression by type of acute coronary syndrome and no significant mean differences on Depression for patients with and without left ventricular failure. Patients with acute myocardial infarction and ventricular fibrillation scored lower on Depression than other patients with acute myocardial infarction and control group. This study supports the view that patients with acute myocardial infarction and ventricular fibrillation and lower scores on Depression have good prognosis during hospitalization and maybe for the long term.

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.

Bortner type A scores and basic emotions: aggression, distrustful, depression, and gregarious.

We examined the correlations between scores on Bonners scale and measures of aggression, distrustful, gregarious, and depression in 1,084 employees. Prospectively over 2 yr. we investigated the relationship of Type A behavior with cardiac mortality. Subjects classified as Type A had higher mean ratings on measures of aggression and distrustful than did persons classified as Type B. Mortality was lower in patients classified as reporting Type A behavior (12%) than in the patients classified as reporting Type B behavior (22%).

Components of Type a Behavior and Two-Year Prognosis of Patients with Acute Coronary Syndrome

We investigated prospectively the relationship of Type A behavior and its subcomponents with cardiac mortality and recurrent nonfatal cardiac events in a 2-yr. follow-up of 90 patients [69 men and 21 women, M age = 56.4 yr., SD = 8.4] after acute coronary syndrome. Type A behavior was assessed via the general Bortner Type A Index. Each patient completed the Bortners scale before hospital discharge During the first 2-yr. follow-up, there were 14 cardiac deaths among patients with myocardial infarction. 8 patients had recurrent cardiac events and were hospitalized, and 19 patients had an effort-induced angina pectoris. Patients with acute myocardial infarction who died during follow-up had a significantly lower Bortner score than patients with a secondary cardiac event. Bortner scores of patients with acute myocardial infarction who died indicated Type B behavioral patterns. Mortality was significantly higher in the patients classified as showing Type B (21.8%) behavior than in the patients classified as showing Type A (12.0%) behavior. Patients with a secondary cardiac event had more common Type A behavior patterns and higher Bortner scores than patients without a secondary cardiac event. The items on Bortners scale “very competitive, ever rushed, tries to do too many things at once, fast in daily activities and expresses feelings” were inversely associated with cardiac deaths. These findings suggest that patients with acute coronary syndrome classified by scores on the Bortner scale as Type B behavior have a greater probability of death, and patients classified on the Bortner scale as Type A behavior have a greater probability of secondary cardiac events during follow-up. This finding may have implications for the treatment of patients with acute coronary syndrome. The inferior survival of patients with Type B personalities argues against attempts to modify Type A behavior in postinfarction patients.