بررسی نقش متغیرهای روانشناختی و اهمیت روان‌درمانی در آسیب‌شناسی روانی بیماران قلبی

Background and Objective: In recent decade cardiovascular diseases have been one of the main causes of death in the world. One of its insidious forms is coronary heart disease. There are number of factors that may contribute to incidence of coronary heart disease and physical and its psychological side effects. The present study investigates whether type D personality, emotional intelligence, stress and coping styles could predict psychopathology in coronary heart disease patients. Following this, we discuss the importance of psychotherapy in treatment of patients with heart disease. Materials and Methods: Participants (n=180) filled out the questionnaires of Type D personality, Coping Style, the Perceived Stress Scale, the Emotional Intelligence Questionnaire and Psychopathology Scale. Regression analysis was used to test if each one of these factors could significantly predict psychopathology in coronary heart disease patients. Results: The results indicated the predictors had the potential to account for 73% of the variance (R2 =.737, F=68.18, p<.01). Moreover, the results pointed out to low scores of psychopathology among coronary heart disease patients in Type D personality, stress and emotional coping style while high scores related to emotional intelligence and problem solving coping style. Conclusion: The findings of the present study showed that the psychological factors have prominent role in predisposing to heart disease as well as its intensification along with its side effects. Psychotherapy application in pre and post episode of disease has important role in treatment and decreasing of psychological side effects and improving the quality of life. Therefore, trainings on stress management, adaptive coping styles and EQ education can reduce coronary heart disease and subsequent mortality as well as psychopathology. References 1- Sabahi F, Akbarzadeh Tootoonchi M. Comparative evaluation of risk factors in coronary heart disease based on fuzzy probability-validity modeling. J Zanjan Univ Med Sci. 2014 22: 73-83. 2- Seema P, Kini LKD. Overview of health status quality-of-life measures review article. J Dermato Clin. 2012 30: 209-21. 3- Cepeda B, Cheong AP, Lee A, Yan BP. Measuring health related quality of life in coronary heart disease: the importance of feeling well. Int J Cardiol. 2011 149: 4-9. 4- Wan C, Jiang R, Tu XM, et al. The hypertension scale of the system of quality of life instruments for chronic diseases, QLICD-HY: a development and validation study. Int J Nurs Stud. 2012 49: 465-80. 5- Kim MY, Johnson J, Sawatzky R, Jillings C. Relationship between types of social support, coping strategies, and psychological distress in individuals living with congenital heart disease. Canadian J Cardiol. 2011 27: 340. 6- Beatriz Cepeda-Valery APC, Andrea Lee, Bryan P. Yan. Measuring health related quality of life in coronary heart disease: the importance of feeling well. Int J Cardiol. 2011 149: 4-9. 7- Nourooz- Zadeh J, Eftekhar E, Haghparast F, Khademwatan, Ekhlasmand M. Evaluation of measures of oxidative stress in patients with proven coronary artery disease (CAD) compared with normal persons. J Zanjan Univ Med Sci. 2007 15: 47-56. 8- Bhimaraj A, Tang WH. Role of oxidative stress in disease progression in stage B, a Pre-cursor of Heart Failure. Heart Fail Clin. 2012 8: 101-11. 9- Pelle A, Broek K, Szabo B, Kupper N. The relationship between type D personality and chronic heart failure is not confounded by disease severity as assessed by BNP. Int J Cardiol. 2010 145: 82-3. 10- Hill EM, Maggi S. Emotional intelligence and smoking: protective and risk factors among Canadian young adults. J Pers Indivi Diff. 2011 51: 45-50. 11- Day RC, Freedland KE, Carney RM. Effects of anxiety and depression on heart disease attributions. Int J Behav Med. 2005 12: 24-29. 12- Soltani Shal R. Aghamohammadian Sharbaf HR .Survey the prevalence of psychopathology in coronary heart disease patients: a casual model based on analysis of the role of psychological factors. Jundishapur J Chronic Dis Care. 2013 2: 56-71. 13- Vahedian Azimi A, Sadeghi M, Movafegh A, et al. The relationship between perceived stress and the top five heart disease characteristics in patients with myocardial infarction. J Zanjan Univ Med Sci. 2012 20: 100-112. 14- Koohestani H, Zand S, Baghcheghi N, Rezai K. Frequency of risk factors for atherosclerosis in children with family history of premature myocardial infarction. J Zanjan Univ Med Sci. 2009 17: 35-44. 15- Cunningham J, McCrum-Gardner E. Power, effect and sample size using Gpower: practical issues for researchers and members of research ethics committees. J Evidence Based Midwifery. 2007 5: 132-6. 16- Froozandeh N, Dalaram M. Effects of cognitive behavional therapy on the coping strategies of non- medical students of shahrekord-university of medical sciences. J Shahrekord Univ Med Sci. 2003 5: 26-34. 17- Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983 24: 385-96. 18- Marani M. standardization of petridze and farenham emotional intelligence questionnaire in university and high school students of Isfahan city (Persian). Isfahan: University of Isfahan. 2003. 19- Ahmadi Poor Mobarake A. The construction and validation of type D personality and it's relation with coronary heart disease. J Know Res App Psychol. 2007 32: 37-60. 20- WHOQOL group. Development of the world health organization WHOQOL-BREF. Quality of life assessment. J Psychol Med. 1998: 551-8. 21- Nejat S, Montazeri A Naieni K, Mohammad K, Majdzadeh SR. Validation and normalization world health organization quality of life questionnaire. The word health organization quality of life questionnaire: translation and validation study of the Iranian version. 2006 4: 1-12. 22- Najarian B, Davodi I. Structuring and validating Scl-25. Short form of scl-90. J Psychol. 2000 18: 136-149. 23- Seldenrijk A, Avijit P, Brenda W, Steptoe A. Psychological distress, cortisol stress response and subclinical coronary calcification. J Psychoneuroendocrinology. 2012 37: 48-55. 24- Yu DSF, Thompson DR, Yu CM, Pedersen SS, Denollet J. Validating the type D personality construct in Chinese patients with coronary heart disease. J Psychosom Res. 2010 69: 111-8. 25- Alipour A, Ahmadi Azghandi A, Mahabadi Z. The predictive role of emotional intelligence in cardiovascular disease: considerations in prevention area. Quarterly J Health Psychol. 2012 1: 32-45. 26- Lopez C, Antoni M, Penedo F, et al. A pilot study of cognitive behavioral stress management effects on stress, quality of life, and symptoms in persons with chronic fatigue syndrome. J Psychosom Res. 2012 70: 328-34. 27- Pourang P, Besharat MH. An investigation of the relationship between coping styles and psychological adaptation with recovery process in a sample of coronary heart disease patients. J Procedia - Soc Behav Sci. 2011: 171-5. 28- Richardson S, Shaffer JA, Falzon L, Krupka D, Davidson KW, Edmondson D. Meta-analysis of perceived stress and its association with incident coronary heart disease. Am J Cardiol. 2012 110: 1711-6. 29- Humphrey LL, Fu R, Rogers K, Freeman M, Helfand M. Homocysteine level and coronary heart disease incidence: a systematic review and meta-analysis. Mayo Clin Proc. 2008 83: 1203-12. 30- Rhee H, Jeon YK, Kim SS, et al. Adrenocorticotropic hormone-independent macronodular adrenal hyperplasia with abnormal cortisol secretion mediated by catecholamines. Korean J Intern Med. 2014 29: 667-70. 31- Akbari M, Mahmood Aliloo M, Aslanabadi N. Relationship between stress and coping styles with coronary heart disease: role of gender factor. Iran J Psychaitry clin Psychol. 2010 15: 368-76. 32- Denollet J, Depotter BR. Coronary heart disease and repressive coping in women with coronary heart disease. Int J Cardiol. 2003 75: 25-41. 33- Mayon R, Beryant B. Quality of life in cardiovascular disease. Br Heart J. 1993 69: 460-6. 34- Jamieson M. Factors influencing health related quality of life in cardiac rehabilitation patient. Prog Cardiovasc Nurs. 2002 17: 124-31. 35- Karner A, Goransson A, Bergdahl B. Conceptions on treatment and lifestyle in patients with coronary heart disease - a phenomenographic analysis. Patient Educ Couns. 2004 47: 137-43.