The relationship of chronic stress response to cardiovascular risk in major depressive disorders

Objective: Depression and cardiovascular diseases are among the most common causes of loss of ability in Turkey and in the world. However, there are a limited number of studies evaluating the risk of developing cardiovascular disease in depression. The aim of this study was to investigate the risk of depression and cardiovascular disease among patients with major depressive disorder and healthy volunteers. It is planned to observe whether there is a difference in cardiovascular risk according to depression subtypes. At the same time, it is aimed to evaluate the possible chronic stress response in this relationship by using the trauma and stress level related scales. Method: 58 patients who were admitted to the Psychiatry Clinic of Dokuz Eylül Hospital, diagnosed as major depressive disorder and received from 21-item Hamilton Depression Rating Scale 18 points and above, and 58 healthy volunteers showing similar features in terms of age and sex were included in this study. Index of atypia was calculated in depressive patients after the implementation of the version of Hamilton Depression Rating Scale for seasonal mood. In both groups, 10 year-Framingham Cardiovascular Risk Score based on body mass index was used to evaluate the risk of cardiovascular disease. In order to determine the place of chronic stress response in this relationship, Perceived Stress Scale and Traumatic Experiences Checklist were applied to the patient and control groups. Results: As a result of comparisons between patients with depression and healthy control group; no significant difference was found between Framingham Cardiovascular Risk Scores among patients with depression and healthy controls (p=0,95). No differences were detected between two groups in terms of diabetes (p=0,75), hypertension (0,82), cardiovascular disease history in first degree relatives (p=0,13), mean systolic blood pressure (0,48), mean diastolic blood pressure (p=0,44), body mass index (0,34), smoking (0,56), alcohol (0,39) and substance use (p=0,56) which are risk factors for cardiovascular disease. The mean monthly income per person was lower in the depression group (p = 0.001). Perceived Stress Scale (p = 0,000), Traumatic Experiences Checklist total score (p = 0,001), emotional neglect (p = 0,03), 7-12 years (p = 0,01), 13-18 years of age composite trauma total score (p = 0.03) and composit trauma total score (p = 0.04) were significantly higher in depression group. Significant correlation was found among index of atypia with body mass index (p <0.01) and total traumatic experience (p <0.05) in depressive patients. Sexual abuse composite trauma total score and mean systolic blood pressure were found to be negatively correlated in the depression group (p <0.05). Conclusion: Because of the risk calculating method, group that consists of young aged and mostly female participants and low number of depressed episodes, it was thought that the risk of cardiovascular disease was found similar among healthy control group and depression patients. The results of this study show that better risk calculation methods should be used in larger samples in the investigation of the relationship between depression and cardiovascular diseases and there is a need to make studies that are reinforced with biological markers. Keywords: depression, cardiovascular disease risk, chronic stress, trauma