Stress in relationship with somatic conditions and mood disorders

Ursu Alina Student, Minodora Manea MD, PhD.Department of Clinical Psychology and Mental Health, „Iuliu

Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania

ABSTRACT

Stress is a part of any person’s life, irrespective of age, and is often linked with a variety of affective disorders and somatic conditions.

The objectives of this study consist in assessing the intensity of stress level, depression, and their relationship with environment and

marital status, and also in assessing defense mechanisms employed by patients in psychiatry, cardiology and oncology clinics.

the purpose is to assess stress, depression and coping mechanisms used by the three aforementioned patient groups, and also the correlationbetween these.

Method. Social Readjusment Rating Scale, Montgomery Asberg Depression Rating Scale and Defense Mechanisms Assessment Scale were

employed in 60 patients.

Results. 91.7% of assessed patients go through a life crisis, while 88.4% of them present with various levels of depression; stress levels and

depression appear to be higher in patients from psychiatric clinics, and in those from an urban environment. Widowed subjects present with

higher levels of depression, compared with divorced and married ones, in the groups of psychiatric and oncology patients.

Conclusions. Patients with medical conditions mostly go through a moderate life crisis and present with mild depression, while those

with mood disorders go through major life crisis and present with moderate depression. Denial is the defense mechanism mostly employed

by both patient groups; psychiatric and oncology patients use denial, while cardiology ones employ repression.

INTRODUCTION

Stress is a part of any person’s life, irrespective of age, and is often linked with a variety of somatic conditions and

affective disorders.Stress promotes the disease by altering the neoplastic cells involved in immune defense (NK cells,T helper cells and suppressor T cells) and repair system for DNA chain.On cardiovascular system, stress produces

normal physiological responses, but by frequent repetition or brutality stressor agent, stress may promote the occurrence

of organic disease.

Depression is closely linked to stress, which is involved both in the onset of first depressive episode, as well as depressive relapses.

OBJECTIVES

1.to asses the correlation between stress, depression and coping mechanisms used by patients from psychiatry, cardiology

and oncology clinics.

2.to identify the intensity of stress level, depression and the defense mechanism employed by the three aforementioned

patient groups.

3.to analyze the relationship of stress and depression with environment and marital status.

MATERIAL AND METHODS

We investigated 60 patients:

-30 patients of the department of psychiatry, aged between 30 and 71, 9 men and 21 women, diagnosed with depression

- 15 patients from the oncology, aged between 44 and 70 years; the group is composed exclusively of women,

the followed pathology is represented by breast cancer

-15 patients from the cardiology, aged between 24 and 72 years, 9 men and 6 women; the followed pathologies

is hypertension, angina pectoris and myocardial infarction

We applied 3 questionnaires to identify:

1 stress level- Social Readjusment Rating Scale

2. intensity of depression- Montgomery Asberg Depression Rating Scale

3.defense mechanisms employed by the patients-Defense Mechanisms Assessment Scale

The relationship between stress levels, intensity of depression and defense mechanism used by the patients was made with

the correlation established by calculating Person correlation coefficient.

CONCLUSIONS

1.Patients with depression experience a major life crisis and reach moderat-severe levels of depressive episodes.

2. Patients with medical conditions (cardiology and cancer diseases) mostly go through a moderate life crisis and reach minor-

moderat levels of depressive episodes.

3.Denial is the defense mechanism mostly employed by psychiatric and oncology patients.

4. Cardiology patients use repression as a coping mechanism.

5.Stress favors depression, both being higher in urban subjects.

REFERENCES

1. Dumitrascu D. (2007), Psychosomatic Medicine , Editura Medicala Universitara

Iuliu Hatieganu , pp 103-115

2. Saner H (2005), Stress as a cardiovascular risk factor Ther Umsch.Sep;62(9):597-

602

3. Barker DB. Antecedents of stressful experiences: Depressive symptoms, self-

esteem, gender, and coping. International Journal of Stress Management.

2007;14:333–349

4. Grecu G, Grecu G. I., Grecu G. M., 2003, Correlations between stressful life events and depressive disorders; Editura Mures, Targu Mures

5. Kendler KS et all Stressful life events, genetic liability, and onset of an episode of major depression in women. Am J Psychiatry. 1995 Jun;152(6):833-42

6. Liu RT, Alloy LB Stress generation in depression: A systematic review of the empirical literature and recommendations for future study. Clin Psychol

Rev. 2010Jul;30(5):582-93

RESULTS

Results show that 91.7% of assessed patients go through a life crisis; 43.3% of depressed patients experience severe life

crisis (fig 1).

88.4% of the subjects present with various levels of depression (fig 2).

The main defense mechanism used by two groups of three is denial (fig 3).

Stress level is higher in urban enviromment subjects, concerning major (63.6%) and moderate stress (65.2%) compared

with rural enviromment (36.6 major and 34.7% moderate stress).

Intensity of depression is higher in urban areas, concerning major (60%), moderate (59.2%) and minor (76.9%) depression.

Degree of depression is higher in widowed subjects in the group of psychiatry and oncology.

The correlation between stress and depression is direct proportionality, thus increasing stress levels favors depression

(r =0,57 ; p<0.05) (fig 4).

The relationship between stress, depression and scores obtained from the questionnaire SEMCA is indirect

proportionalitaty, thereby increasing stress levels and depression are associated with low scores at SEMCA (r= -0,41;

p=0,02 pentru depresie, r= -0,34 for stress)

Correlation between MADRS and SRRS

y = 9,2015x - 3,0206

R2 = 0,3325

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score MADRS

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Comparison between the frequency of defense

mechanisms at patients with somatic diseases and

affective disorder

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patients with somatic conditions(cardiology and oncology)

patients with affective disorder(depression)

Comparison regarding the intensity of depression between patients

with somatic conditions and affective disorder

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absence of depression minor depression moderat depression major depression

patients with somatic conditions (cardiology and oncology)

patients with affective disorder (depression)

Comparison according to the level of stress between patients with somatic

conditions and affective disorder

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without stress minor stress moderat stress major stress

patients with somatic conditions(oncology and cardiology)

patients with affective disorder(depression)

Figure 1 Comparison according to the level of stress between pacient with somatic conditions and affective disorder.

Figure 2 Comparios regarding the intensity of depresion between patients with somatic and affectice disorder.

Figure 3 Comparison between the frewvency of defence mechanism at patients with somatic diseases and affective

disorder.

Figure 4 Correlation between MADRS and SRRS from psyhiatry group patients , r=0,57; p<0.05

RESULTS