Detection and treatment of mental disorders in patients with coronary heart disease (MenDis-CHD): A cross-sectional study

• Published in: PloS one 2020-12, Vol.15 (12), p.e0243800-e0243800
• Main Authors: Peltzer, Samia, Müller, Hendrik, Köstler, Ursula, Schulz-Nieswandt, Frank, Jessen, Frank, Albus, Christian
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Anxiety; Anxiety - pathology; Anxiety disorders; Biology and Life Sciences; Cardiology; Cardiovascular disease; Cardiovascular diseases; Care and treatment; Chi-square test; Chronic conditions; Comorbidity; Coronary artery disease; Coronary Disease - complications; Coronary Disease - pathology; Coronary heart disease; Cross-Sectional Studies; Diagnosis; Diagnostic and Statistical Manual of Mental Disorders; Diagnostic systems; Female; Health services; Heart diseases; Humans; Male; Medical diagnosis; Medical treatment; Medicine and Health Sciences; Mental disorders; Mental Disorders - complications; Mental Disorders - diagnosis; Mental Disorders - therapy; Mental illness; Middle Aged; Morbidity; Mortality; Patient Satisfaction; Patients; People and Places; Physicians; Psychotherapy; Quality of Life; Rehabilitation; Severity of Illness Index; Social Sciences; Statistical tests; Variance analysis
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0243800

Mental disorders (MD) are associated with an increased risk of developing coronary heart disease (CHD) and with higher CHD-related morbidity and mortality. There is a strong recommendation to routinely screen CHD patients for MDs, diagnosis, and treatment by recent guidelines. The current study aimed at mapping CHD patients' (1) state of diagnostics and, if necessary, treatment of MDs, (2) trajectories and detection rate in healthcare, and (3) the influence of MDs and its management on quality of life and patient satisfaction. The design was a cross-sectional study in three settings (two hospitals, two rehabilitation clinics, three cardiology practices). CHD patients were screened for MDs with the Hospital Anxiety and Depression Scale (HADS), and, if screened-positive, examined for MDs with the Structured Clinical Interview for DSM-IV (SCID-I). Quality of Life (EQ-5D), Patient Assessment of Care for Chronic Conditions (PACIC), and previous routine diagnostics and treatment for MDs were examined. Descriptive statistics, Chi-squared tests, and ANOVA were used for analyses. Analyses of the data of 364 patients resulted in 33.8% positive HADS-screenings and 28.0% SCID-I diagnoses. The detection rate of correctly pre-diagnosed MDs was 49.0%. Physicians actively approached approximately thirty percent of patients on MDs; however, only 6.6% of patients underwent psychotherapy and 4.1% medication therapy through psychotherapists/psychiatrists. MD patients scored significantly lower on EQ-5D and the PACIC. The state of diagnostic and treatment of comorbid MDs in patients with CHD is insufficient. Patients showed a positive attitude towards addressing MDs and were satisfied with medical treatment, but less with MD-related advice. Physicians in secondary care need more training inadequately addressing mental comorbidity.