Iranian Red Crescent Medical Journal

Published by: Kowsar

Anxiety, Depression, Coronary Artery Disease and Diabetes Mellitus; an Association Study in Ghaem Hospital, Iran

Mohammad Tajfard 1 , 2 , Majid Ghayour Mobarhan 3 , * , Hamid Reza Rahimi 4 , Mohsen Mouhebati 5 , Habibollah Esmaeily 6 , Gordon A Ferns 7 , Latiffah A Latiff 1 , * , Ali Taghipour 6 , Naghmeh Mokhber 8 and Ahmad Fazli Abdul-Aziz 9
Authors Information
1 Department of Community Health, Faculty of Medicine and Health Sciences, University Putra Malaysia, Kuala Lumpur, Malaysia
2 Health Sciences Research Center, Department of Health and Management, School of Health, Mashhad University of Medical Sciences, Mashhad, IR Iran
3 Cardiovascular Research Center, Avicenna (Bu-Ali) Research Institute, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
4 Student Research Committee, Department of Modern Sciences and Technologies, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
5 Department of Cardiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
6 Health Sciences Research Center, Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, IR Iran
7 Brighton and Sussex Medical School,University of Sussex, Brighton, UK
8 Psychiatry and Behavioral Sciences Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran
9 Department of Medicine, Faculty of Medicine and Health Sciences, University Putra Malaysia, Selangor, Malaysia
Corresponding Authors:
Article information
  • Iranian Red Crescent Medical Journal: September 01, 2014, 16 (9); e14589
  • Published Online: August 17, 2014
  • Article Type: Research Article
  • Received: November 18, 2013
  • Revised: February 5, 2014
  • Accepted: March 17, 2014
  • DOI: 10.5812/ircmj.14589

To Cite: Tajfard M, Ghayour Mobarhan M, Rahimi H R, Mouhebati M, Esmaeily H, et al. Anxiety, Depression, Coronary Artery Disease and Diabetes Mellitus; an Association Study in Ghaem Hospital, Iran, Iran Red Crescent Med J. 2014 ; 16(9):e14589. doi: 10.5812/ircmj.14589.

Copyright © 2014, Iranian Red Crescent Medical Journal. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Background
2. Objectives
3. Patients and Methods
4. Results
5. Discussion
  • 1. Antonogeorgos G, Panagiotakos DB, Pitsavos C, Papageorgiou C, Chrysohoou C, Papadimitriou GN, et al. Understanding the role of depression and anxiety on cardiovascular disease risk, using structural equation modeling; the mediating effect of the Mediterranean diet and physical activity: the ATTICA study. Ann Epidemiol. 2012; 22(9): 630-7[DOI][PubMed]
  • 2. Murray CJL, Lopez AD. The global burden of disease and injury series, volume 1: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Cambridge. MA. 1996;
  • 3. Lindeberg SI, Rosvall M, Ostergren PO. Exhaustion predicts coronary heart disease independently of symptoms of depression and anxiety in men but not in women. J Psychosom Res. 2012; 72(1): 17-21[DOI][PubMed]
  • 4. Shen BJ, Eisenberg SA, Maeda U, Farrell KA, Schwarz ER, Penedo FJ, et al. Depression and anxiety predict decline in physical health functioning in patients with heart failure. Ann Behav Med. 2011; 41(3): 373-82[DOI][PubMed]
  • 5. Frasure-Smith N, Lesperance F. Depression and anxiety as predictors of 2-year cardiac events in patients with stable coronary artery disease. Arch Gen Psychiatry. 2008; 65(1): 62-71[DOI][PubMed]
  • 6. Dempe C, Junger J, Hoppe S, Katzenberger ML, Moltner A, Ladwig KH, et al. Association of anxious and depressive symptoms with medication nonadherence in patients with stable coronary artery disease. J Psychosom Res. 2013; 74(2): 122-7[DOI][PubMed]
  • 7. Tull MT, Gratz KL. Further examination of the relationship between anxiety sensitivity and depression: the mediating role of experiential avoidance and difficulties engaging in goal-directed behavior when distressed. J Anxiety Disord. 2008; 22(2): 199-210[DOI][PubMed]
  • 8. Hadi N, Asadollahi R, Talei AR. Anxiety, Depression and Anger in Breast Cancer Patients Compared with the General Population in Shiraz, Southern Iran. IRCMJ. 2009; 11(3): 312
  • 9. Palizgir M, Bakhtiari M, Esteghamati A. Association of depression and anxiety with diabetes mellitus type 2 concerning some sociological factors. Iran Red Crescent Med J. 2013; 15(8): 644-8[DOI][PubMed]
  • 10. Licinio J, Wong ML. The role of inflammatory mediators in the biology of major depression: central nervous system cytokines modulate the biological substrate of depressive symptoms, regulate stress-responsive systems, and contribute to neurotoxicity and neuroprotection. Mol Psychiatry. 1999; 4(4): 317-27[PubMed]
  • 11. Zorrilla EP, Luborsky L, McKay JR, Rosenthal R, Houldin A, Tax A, et al. The relationship of depression and stressors to immunological assays: a meta-analytic review. Brain Behav Immun. 2001; 15(3): 199-226[DOI][PubMed]
  • 12. Penninx BW, Kritchevsky SB, Yaffe K, Newman AB, Simonsick EM, Rubin S, et al. Inflammatory markers and depressed mood in older persons: results from the Health, Aging and Body Composition study. Biol Psychiatry. 2003; 54(5): 566-72[PubMed]
  • 13. Leonard BE, Myint A. The psychoneuroimmunology of depression. Hum Psychopharmacol. 2009; 24(3): 165-75[DOI][PubMed]
  • 14. Schiepers OJ, Wichers MC, Maes M. Cytokines and major depression. Prog Neuropsychopharmacol Biol Psychiatry. 2005; 29(2): 201-17[DOI][PubMed]
  • 15. Lupien SJ, McEwen BS, Gunnar MR, Heim C. Effects of stress throughout the lifespan on the brain, behaviour and cognition. Nat Rev Neurosci. 2009; 10(6): 434-45[DOI][PubMed]
  • 16. Maes M. Evidence for an immune response in major depression: a review and hypothesis. Prog Neuropsychopharmacol Biol Psychiatry. 1995; 19(1): 11-38[PubMed]
  • 17. Rethorst CD, Toups MS, Greer TL, Nakonezny PA, Carmody TJ, Grannemann BD, et al. Pro-inflammatory cytokines as predictors of antidepressant effects of exercise in major depressive disorder. Mol Psychiatry. 2013; 18(10): 1119-24[DOI][PubMed]
  • 18. Arranz L, Guayerbas N, De la Fuente M. Impairment of several immune functions in anxious women. J Psychosom Res. 2007; 62(1): 1-8[DOI][PubMed]
  • 19. Pitsavos C, Panagiotakos DB, Papageorgiou C, Tsetsekou E, Soldatos C, Stefanadis C. Anxiety in relation to inflammation and coagulation markers, among healthy adults: the ATTICA study. Atherosclerosis. 2006; 185(2): 320-6[DOI][PubMed]
  • 20. Blumenfield M, Suojanen JK, Weiss C. Public awareness about the connection between depression and physical health: specifically heart disease. Psychiatr Q. 2012; 83(3): 259-69[DOI][PubMed]
  • 21. Pedersen SS, Herrmann-Lingen C, de Jonge P, Scherer M. Type D personality is a predictor of poor emotional quality of life in primary care heart failure patients independent of depressive symptoms and New York Heart Association functional class. J Behav Med. 2010; 33(1): 72-80[DOI][PubMed]
  • 22. Steinberg G, Lossnitzer N, Schellberg D, Mueller-Tasch T, Krueger C, Haass M, et al. Peak oxygen uptake and left ventricular ejection fraction, but not depressive symptoms, are associated with cognitive impairment in patients with chronic heart failure. Int J Gen Med. 2011; 4: 879-87[DOI][PubMed]
  • 23. Rutledge T, Reis VA, Linke SE, Greenberg BH, Mills PJ. Depression in heart failure a meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes. J Am Coll Cardiol. 2006; 48(8): 1527-37[DOI][PubMed]
  • 24. Gallagher D, O'Regan C, Savva GM, Cronin H, Lawlor BA, Kenny RA. Depression, anxiety and cardiovascular disease: which symptoms are associated with increased risk in community dwelling older adults? J Affect Disord. 2012; 142(1-3): 132-8[DOI][PubMed]
  • 25. Ansari Gilani K, Fallahi B, Modaresi Esfeh J, Shahidzadeh Mahani M. Effects of depression on myocardial perfusion scintigraphy [Persian]. Iranian J Nuclear Med. 2006; 14(2): 1-7
  • 26. Pradhan AD, Manson JE, Rifai N, Buring JE, Ridker PM. C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. JAMA. 2001; 286(3): 327-34[PubMed]
  • 27. Alamdari DH, Ghayour-Mobarhan M, Tavallaie S, Parizadeh MR, Moohebati M, Ghafoori F, et al. Prooxidant-antioxidant balance as a new risk factor in patients with angiographically defined coronary artery disease. Clin Biochem. 2008; 41(6): 375-80[DOI][PubMed]
  • 28. Derosa G, Ferrari I, D'Angelo A, Salvadeo SA, Fogari E, Gravina A, et al. Oral fat load effects on inflammation and endothelial stress markers in healthy subjects. Heart Vessels. 2009; 24(3): 204-10[DOI][PubMed]
  • 29. Wamala SP, Mittleman MA, Schenck-Gustafsson K, Orth-Gomer K. Potential explanations for the educational gradient in coronary heart disease: a population-based case-control study of Swedish women. Am J Public Health. 1999; 89(3): 315-21[PubMed]
  • 30. Kazemi-Bajestani SM, Ghayour-Mobarhan M, Ebrahimi M, Moohebati M, Esmaeili HA, Ferns GA. C-reactive protein associated with coronary artery disease in Iranian patients with angiographically defined coronary artery disease. Clin Lab. 2007; 53(1-2): 49-56[PubMed]
  • 31. Leyfer OT, Ruberg JL, Woodruff-Borden J. Examination of the utility of the Beck Anxiety Inventory and its factors as a screener for anxiety disorders. J Anxiety Disord. 2006; 20(4): 444-58[DOI][PubMed]
  • 32. Beck AT, Steer RA, Garbin MG. Psychometric properties of the Beck depression inventory: twenty-five years of evaluation. Clin Psychol Rev. 1998; 8: 77-100
  • 33. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961; 4: 561-71[PubMed]
  • 34. Kaviani H, Mousavi AS. Psychometric properties of the Persian version of Beck Anxiety Inventory (BAI). Tehran Univ Med J. 2008; 66(2): 136-40
  • 35. Faramarzi M, Alipor A, Esmaelzadeh S, Kheirkhah F, Poladi K, Pash H. Treatment of depression and anxiety in infertile women: cognitive behavioral therapy versus fluoxetine. J Affect Disord. 2008; 108(1-2): 159-64[DOI][PubMed]
  • 36. Vasegh S, Mohammadi MR. Religiosity, anxiety, and depression among a sample of Iranian medical students. Int J Psychiatry Med. 2007; 37(2): 213-27[PubMed]
  • 37. Javnbakht M, Hejazi Kenari R, Ghasemi M. Effects of yoga on depression and anxiety of women. Complement Ther Clin Pract. 2009; 15(2): 102-4[DOI][PubMed]
  • 38. Ghassemzadeh H, Mojtabai R, Karamghadiri N, Ebrahimkhani N. Psychometric properties of a Persian-language version of the Beck Depression Inventory--Second edition: BDI-II-PERSIAN. Depress Anxiety. 2005; 21(4): 185-92[DOI][PubMed]
  • 39. Miller GE, Freedland KE, Carney RM, Stetler CA, Banks WA. Pathways linking depression, adiposity, and inflammatory markers in healthy young adults. Brain Behav Immun. 2003; 17(4): 276-85[PubMed]
  • 40. 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(12): 1711-6[DOI][PubMed]
  • 41. Rozanski A, Blumenthal JA, Kaplan J. Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation. 1999; 99(16): 2192-217[PubMed]
  • 42. Kawachi I, Colditz GA, Ascherio A, Rimm EB, Giovannucci E, Stampfer MJ, et al. Prospective study of phobic anxiety and risk of coronary heart disease in men. Circulation. 1994; 89(5): 1992-7[PubMed]
  • 43. Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation. 2002; 105(9): 1135-43[PubMed]
  • 44. Zernecke A, Shagdarsuren E, Weber C. Chemokines in atherosclerosis: an update. Arterioscler Thromb Vasc Biol. 2008; 28(11): 1897-908[DOI][PubMed]
  • 45. Martins TB, Anderson JL, Muhlestein JB, Horne BD, Carlquist JF, Roberts WL, et al. Risk factor analysis of plasma cytokines in patients with coronary artery disease by a multiplexed fluorescent immunoassay. Am J Clin Pathol. 2006; 125(6): 906-13[DOI][PubMed]
  • 46. Tiemeier H, Hofman A, van Tuijl HR, Kiliaan AJ, Meijer J, Breteler MM. Inflammatory proteins and depression in the elderly. Epidemiology. 2003; 14(1): 103-7[DOI][PubMed]
  • 47. Pickup JC, Mattock MB, Chusney GD, Burt D. NIDDM as a disease of the innate immune system: association of acute-phase reactants and interleukin-6 with metabolic syndrome X. Diabetologia. 1997; 40(11): 1286-92[DOI][PubMed]
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