Predictive factors of mental disorders in patients with suspected ischaemic cardiopathy

Objective: To identify the predictive factors of mental disorders in patients with suspected Ischaemic Cardiopathy (IC). Method: The patients admitted to the Cardiology Service of an University Hospital (SW Spain) for acute thoracic pain with suspected IC were studied. Patients were classified into four diagnostic groups (acute myocardial infarction, unstable angina, non-ischaemic cardiological process, non-cardiological) based on clinical, electrocardiographical and biochemical data. The sociodemographic and clinical variables were obtained by a 'ad hoc' questionnaire and the clinical records of the patient. The GHQ-28 questionnaire was used to assess the status of mental health, and a score of greater than or equal to6 was taken as the cut-off point for being a 'probable psychiatric case'. Crude odds ratios (OR +/- 95% CI), and adjusted OR according to a logistic model, were calculated in order to study the variables associated with the mental disorders. The tabulation and analysis of data was carried out with the SPSS v.8 (for Windows) program. Results: From June 1996 to November 1997, 185 patients were studied; 72% were males and the mean age was 60.2 years (SD = 10.4). 49.2% of the patients were scored at greater than or equal to6 on the GHQ-28, and the sub-scale accounting for the highest scores was that of somatic symptoms of psychological origin. The adjusted ORs showed that female sex (OR: 2.5; 95% CI: 1.2-5.0), previous personal history of IC (OR: 2.3; 95% CI: 1.1-4.4), and the presence of arterial hypertension (OR: 2.0; 95% CI: 1.1-3.9), were the predictive variables for being a 'probable psychiatric case', whereas neither age nor comorbidity were predictive. Conclusions: The percentage of subjects considered to be a 'probable psychiatric case' among patients with suspected ischaemic cardiopathy was high. Screening for mental disorders and intervention to control the risk factors associated are measures recommended in these patients.