Temperament and Character Profiles and Psychiatric Comorbidities in Patients With Coronary Artery or Valvular Heart Disease: Relationship With Cardiac Disease Severity

Abstract

Background: We aimed to investigate whether the psychopathological symptoms and temperament-character dimensions observed in patients operated due to coronary artery disease (CAD) or valvular heart disease (VHD) differ among the patients and from healthy individuals.

Methods: Study population was composed of subjects with CAD, VHD and healthy controls (n = 50 in each group). Socio-demographic questionnaire, temperament and character inventory (TCI) and symptom check list-90-R (SCL-90-R) were applied to all groups. Groups were compared about temperament-character dimensions and scores of subscales of SCL-90-R.

Results: Harm avoidance was found to be higher in VHD group than those with CAD and, lower in healthy controls than both patient groups (P = 0.004). Reward dependence was similar among both patient groups and, was higher than healthy group (P = 0.015). Depression, anxiety, somatization, obsession and interpersonal sensitivity were found to be similar in both patient groups but they were higher than those in controls (P < 0.001, P < 0.001, P < 0.001, P = 0.002 and P = 0.003, respectively). Phobia was seen equally in CAD group and healthy controls and, was found to be lower in these than in VHD (P = 0.009). Anger score was in descending order in patients with VHD, CAD and healthy controls group (P = 0.010 and 0.001). Paranoia was in descending order in patients with VHD, CAD and controls (P = 0.015 and 0.001). A weak and inverse correlation was found between ejection fraction (EF) and the persistence dimension of temperament scaled by TCI in patients with VHD (r = -0.276, P = 0.052). An inverse correlation was observed between EF and the reward dependence dimension in CAD group (r = -0.195, P = 0.044). In patients with VHD, EF demonstrated an inversely weak (r = -0.289, P = 0.042), moderate (r = -0.360, P = 0.010) and strong (r = -0.649, P < 0.001) correlation with inter-personal sensitivity, phobia and paranoia, respectively. There was an inverse and weak correlation between EF and depression and anger in VHD group (r = -0.302, P = 0.033 and r = -0.240, P = 0.054).

Conclusion: VHD and CAD exhibit different psychopathological symptoms and temperament traits. There is a correlation between the aforementioned psychopathological symptoms and temperament traits, and EF.




J Clin Med Res. 2016;8(3):202-209
doi: http://dx.doi.org/10.14740/jocmr2440w