Assessment of Association of Psychiatric Disorders on Quality of Life in Patients with Cardiac Disorders

Abstract

Introduction : Cardiovascular diseases are group of disorders of the heart and blood vessels. Which is caused mainly by high blood pressure, high LDL cholesterol, diabetes, smoking and obesity. Psychiatric disorder is characterized by a clinically significant disturbance in an individual’s cognition, emotional regulation, or behaviour. It results from a complex combination of genetic risk, differences in brain development, and exposure to stressors or trauma. Cardiovascular disease has been found to be approximately 1.5–2 times higher in people having severe mental disorders like schizophrenia and bipolar disorder (BPAD). Despite heart conditions significantly impacting quality of life, other factors play an important role as well, including age, sex, medical comorbidities, body mass index, smoking status, social support, depression, and anxiety. While there have been a large number of studies examining particular psychological symptoms with cardiac outcomes and quality of life (QOL), there is a lack of studies that investigate cardiac patients with established psychiatric diagnoses. The hypothesis being tested is that quality of life of cardiac patients with psychiatric disorders is poorer than quality of life of cardiac patients without psychiatric disorders.

Objectives: The study aims to measure the quality of life (QOL) of cardiac patients with psychiatric disorders in comparison to cardiac patients without psychiatric disorders.

Methods: A cross-sectional observational study was conducted in a 450 bedded tertiary care hospital by collecting data patient case sheet and patient medication interview. The study subject involves 120 patients in psychiatry, general medicine and cardiology departments.  

Results: A total of 110 patients were included in this study. The study patients comprise 55 cardiac patients with psychiatric disorders and 55 without psychiatric disorders. Majority of cardiac patients with psychiatric disorders were under 51-60 age bar with a mean age of 55 and cardiac patients without psychiatric disorders were under 71-80 age bar with a mean age of 71. In cardiac patients with psychiatric disorders about 32 were male and in cardiac patients without psychiatric population 31 were male. Among the female population 23 and 24 respectively. In assessing social history alcoholic patients were high. Depression was the predominant psychotic disorder among the subjects 34.5% and hypertension was the predominant cardiac disorder 76.3%. Lorazepam followed by olanzapine were the most prescribed antipsychotics for psychiatric patients and aspirin followed by telmisartan were the most prescribed cardiac drugs. Reconfirmation of psychiatric disorders done by mini-interview. The study revealed that cardiac patients with psychiatric disorders had low domain scores than compared to cardiac patients without psychiatric disorders thereby has reduced quality of life proved by WHOQOL-BREF domain scores.

Conclusions: Psychiatric disorder is a risk factor for poor quality of life in cardiac patients. The cardiac patients with psychiatric disorders require particular attention, social and familial mental, physical emotional support accompanied with adequate life style modifications and medication adherence. Patient counselling and PIL was given to the cardiac patients to increase QOL..