Depression and the risk of adverse outcomes at 5 years in patients with coronary heart disease.

BACKGROUND: Cardiovascular diseases are a public health concern worldwide, with high rates of morbidity and mortality. Depression is a frequent comorbidity in coronary heart disease (CHD). It can be caused by the experience of suffering from heart disease, but it can also influence the prognosis of the CHD. The prevalence of depression in patients with cardiovascular disease is twice as high as that in the general population. AIM: Assess the influence of depression in the prognosis at 5 years in patients with CHD. METHODS: 145 patients diagnosed with CHD were recruited between September 2013 and June 2015. Depression was assessed based on the PHQ-9 results at the time of hospitalization and 3 months after discharged. Sociodemographic and clinical variables were collected. A 5-year follow-up was carried out to verify death, reinfarction or any adverse outcome. RESULTS: 20% of the study population had depression at hospital admission compared with 11% at 3 months. Depression at 3 months after discharged was a differentiating factor to present complications (42.6 months, CI 95% 27.3-57.9) compared with patients without depression (55 months, CI 95%, 50.9-59.1) (Log-Rank p = 0.034). In the unadjusted model, the risk of heart complications increased with patients that have comorbidities, such as diabetes (HR 2.78, 95% CI 1.21-6.3) or hypothyroidism (HR 2.5 95% CI 1.09-5.7). Also, patients with post-hospitalization depression at 3 months were 3 times (95% CI 1.023-8.8) more likely to have complications during the follow-up period than nondepressed patients. After risk factor adjustment, the HR for depression was 2.01 (95% CI 0.57-6.9). FINDINGS: Patients with depression at 3 months following the coronary event, presented complications sooner than those without depression.

Percepción de soledad en la mujer / Perception of loneliness in women

El propósito del presente estudio fue establecer el estado de la cuestión de las investigaciones sobre la soledad y la percepción de la misma. La soledad, en sí misma es considerada como factor de riesgo para trastornos del estado de ánimo, consumo de drogas y suicidio, entre otros, pero también como opción de vida que expresa cambios socioculturales de la época contemporánea. La transformación del rol de la mujer en la pareja, la familia, y la sociedad, conlleva modificación de conceptos sobre el fenómeno de la soledad; para comprenderle no solo, desde una perspectiva negativa, sino también como opción de vida en la mujer. Se concluye a partir de la revisión de antecedentes investigativos, la necesidad de estudiarla junto con otras variables como la autoestima, el apoyo social y la personalidad, las cuales pueden determinarle como riesgo o como factor protector.

The purpose of this study was to establish the status of the issue of investigations into loneliness and its perception. Loneliness itself is considered as a risk factor for mood disorders, drug consumption, and suicide, among some others, but also as a life choice which expresses social and cultural changes of the contemporary era. The transformation of the role of the woman in the couple, the family, and the society, require the modification of concepts about the phenomenon of loneliness; in order to understand not only from a negative perspective, but also as an option of life in women. It is concluded from the review of investigative background, the need to study it together with other variables such as selfesteem, social support, and personality, which can determine it either as a risk or a protective factor.