Hopelessness Case Study
Hopelessness is also a symptom seen in depression where there is an expectation that bad things will happen in the future (55). Hopelessness can be associated with suicidal ideations which may lead to suicide attempts (106). This can further increase the mortality in post MI patients with depression. A patient with hopelessness believes that things will not get better which can lead to physical inactivity (55). CAD patients who also have hopelessness were less likely to participate in cardiac rehabilitation (107).
The interaction between heart and mind works in a dual manner. Cardiac illnesses can cause distress and lead to depressive symptoms or psychological stressors which itself can affect the heart through the autonomic nervous system
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Patients who had MI and psychiatry out patients without MI were assessed with Beck Depression Inventory-II. They did not find a significant difference in the somatic scores between both the groups. The MI patients were also compared to undergraduate psychology students. Somatic symptom scored 52.7% of the total BDI-II scores in the post MI group as compared to 46.4% in the matched student group. Patients who had suffered MI scored higher on somatic symptoms such as fatigue, loss of energy and decreased libido …show more content…
Somatic/affective symptoms were found to have a relationship with poor cardiac outcome even after the somatic health status was controlled at the starting point. When the effect of MI severity on cardiac prognosis and the co-variation of MI severity with somatic symptoms are combined, there is a statistical association between the prognosis of MI patient and the somatic/affective symptoms. Another statistical link may be due to the effect of somatic depressive symptoms on the cardiac prognosis, independent of the severity of the MI (111). Once the severity of cardiac disease was controlled, negative affective symptoms; crying spells, sadness, suicidal ideations, restlessness and irritability were found to be predictive of cardiac mortality (114).
The treatment provided for MI patients with depression needs to be effective in reducing the somatic/affective symptoms as it can improve the cardiovascular outcome (111).
7.0 PAST HISTORY OF DEPRESSION
Depression has been identified as a risk factor for cardiovascular prognosis. There is speculation regarding whether this risk depends on the comorbid depression being a first episode or a recurrent one (115). The patient may have had several depressive episodes prior to the first myocardial infarction or the depression concurrence with MI might be their first depressive
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