Prevalence and Implications of Anxiety and Depression in Cardiovascular Outpatients Following the COVID-19 Pandemic

Abstract

Objective: To investigate the prevalence of depression and/or anxiety among cardiovascular outpatients in a tertiary general hospital following the COVID-19 pandemic. Method: Patients were recruited consecutively from the cardiovascular outpatient department of Weinan Central Hospital, a comprehensive tertiary hospital in the region. Eligible participants were aged 18 years or older, conscious, provided informed consent, and were able to independently complete the questionnaire. On designated survey days, all participants completed a general information form, the three-question method questionnaire, and, for those identified as positive by the initial screening, additional GAD-7 and PHQ-9 assessments. Results: A total of 1,355 valid responses were obtained. Initial screening using the three-question method identified 379 positive cases, accounting for 27.97% (379/1,355). The prevalence of depression was approximately 2.89% (39/1,355), anxiety was 4.87% (66/1,355), and mixed anxiety and depression was 15.28% (207/1,355), indicating that mixed conditions were more common. Among patients presenting with cardiac-like symptoms but diagnosed with non-organic heart disease, over 36% were identified in the outpatient department. In this subgroup, the prevalence of anxiety, depression, and mixed conditions was approximately 25.25%, 23.35%, and 19.56%, respectively. These cases, often categorized as cardiac neurosis, are thought to be associated with emotional and psychological factors and are predominantly observed among young and middle-aged individuals. Among patients with organic heart disease, hypertension was the most prevalent condition, affecting approximately 47.75%, followed by coronary heart disease, heart surgery, arrhythmias, and heart failure. Patients with arrhythmias exhibited the highest rates of anxiety (27.71%), depression (26.51%), and mixed conditions (25.30%). Similarly, among hypertensive patients, the prevalence of anxiety, depression, and mixed conditions was approximately 16.23%, 14.06%, and 11.90%, respectively. These prevalence rates exceed national data from similar studies conducted prior to the COVID-19 pandemic. Conclusion: A high prevalence of anxiety and depression exists among cardiovascular outpatients in general hospitals, with an increasing trend observed after the pandemic. Establishing a psycho-cardiological medical model is essential for improving the diagnosis and treatment of these patients.