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2009 | 4 | 1 | 91-97

Article title

Psychosomatic correlates of coronary heart disease during the socio-economic crisis of post-communist Bulgaria


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Post-communist Bulgaria has experienced the full impact of a socioeconomic disaster. Under prolonged and powerful stress the human body may exhaust its adaptive potential and a variety of pathophysiological symptoms may occur. The cardiovascular system is most vulnerable to stress. The aim of this study is to analyze the role of psychological factors correlating with Acute Myocardial Infarction (AMI) during the transition period in post-communist Bulgaria. A case-control epidemiological study was performed. 306 cases of acute myocardial infarction (AMI) and 210 controls were studied. Analysis of patients’ records was made and a direct face-to-face interview was carried out. The study covers a 15-year transition period lasting from 1989 until 2005. The interview questions are based on W. Zung’s standardized self-evaluation tests of anxiety and depression (Self Rating Depression Scale - SDS, 1965, SAS-Self Rating Anxiety Scale, 1976) and on a test of aggression, as a part of the Minnesota Multiphase personality inventory, adapted from A.A. Krilov and F. Korozi’s FPI test. Average levels of anxiety and depression appear to be higher among patients suffering from coronary heart diseases than in control group members. Levels of aggression do not show a direct correlation with coronary heart disease. Both groups demonstrate symptoms of psychological disturbances caused, most probably, by the socio-economic instability of the transition period. In conclusion, certain socioeconomic factors significantly increase the level of anxiety and depression in the respondents. The AMI patients are considerably more anxious and depressed than the controls. The results provide evidence that high levels of anxiety and depression may correlate to and be interpreted as a potential risk factor for coronary heart disease.










Physical description


1 - 3 - 2009
11 - 2 - 2009


  • Department of Social Medicine, Medical University, 4001, Plovdiv, Bulgaria
  • Department of Preventive Medicine, Faculty of Public Health, Medical University, 1527, Sofia, Bulgaria
  • Department of Social Medicine, Medical University, 1000, Sofia, Bulgaria
  • Clinic of Toxicology, University Hospital “St. George”, 4000, Plovdiv, Bulgaria


  • [1] Markova N., Nowi zdravni riskowe w globalnoto obshtestwo, Soc. medicina, 2002, 2, 5–7 (in Bulgarian)
  • [2] Danelia M., Trapaidze D., Psychosocial work environment and coronary heart disease, Georg. Med. News 2005, 121, 56–58
  • [3] Landy F.J., Quick J., Kasl S., Work stress and well-being, Intern. J. Stress Management, 1994, I(1), 33–73 http://dx.doi.org/10.1007/BF01857282[Crossref]
  • [4] Paunov S., Psihologia na ikonomicheskoto povedenie, Plovdiv, 2004, 64 (In Bulgarian)
  • [5] Csef H., Hefner J., Psychosocial stress as a risk and prognostic factor in coronary artery disease and myocardial infarction, Versicherungsmedizin, 2006, 58, 3–8 [PubMed]
  • [6] Fischer J.E., Work, stress and cardiovascular diseases, Ther. Umsch., 2003, 60, 689–696 http://dx.doi.org/10.1024/0040-5930.60.11.689[Crossref]
  • [7] Mookadam F., Arthur H.M., Social support and its relationship to morbidity and mortality after acute myocardial infarction: systematic overview, Arch. Intern. Med., 2004, 164, 1514–1518 http://dx.doi.org/10.1001/archinte.164.14.1514[Crossref]
  • [8] Sitnik K., Trzcieniecka-Green A., Jakubowski D. et all., “Heart attack in humans” - the health belief model in comparison with the health reality of patients with myocardial infarction, Wiad. Lek., 2004,57, Suppl 1, 285–289
  • [9] Temkov I., Popov H., Stress I krizi na lichnosta, Sofia, Medicina I fizkultura, 1987 (in Bulgarian)
  • [10] Chou K.L., Chi I., Stressful life events and depressive symptoms: social support and sense of control as mediators or moderators?, Int. J Aging Hum. Dev., 2001, 52, 155–171 http://dx.doi.org/10.2190/9C97-LCA5-EWB7-XK2W[Crossref]
  • [11] Ouzuniv N., Stress i psihotrauma, Sofia, Znanie, 2001, 338 (In Bulgarian)
  • [12] Tsonev Ts., Marinov P., Sardechna ischemia, In: Ivanov Vl. (ed.), Prakticheska psihosomatichna medicina, Sofia, Znanie, 1999, 133–138 (in Bulgarian)
  • [13] Karaslavova E., Tdodorova D., Tarnovska T., Chompalova T., Wliyanie na prehodnia period warhu koronarnata sadova bolest w Bulgaria, Soc. medicina, 2007, 2, 35–39 (In Bulgarian)
  • [14] James L., Howard D., Stedman M. et all., A comparison of the Framingham and European Society of Cardiology Coronary Heart Disease Risk Prediction Models in the Normative Aging Study, Am. Heart J 2002, 144, 95–110 http://dx.doi.org/10.1067/mhj.2002.123317[Crossref]
  • [15] Tzonev Tz., Marinov P., Sardechnosadovi zaboljavania, In: Ivanov Vl. (ed.), Prakticheska psihosomatichna medicina, Stara Zgora, Znanie, 1999, 131–143 (In Bulgarian)
  • [16] Selye H., Stress in health and disease, Butterworths, Boston, 1976
  • [17] Ivanov V., Stress i psihosomatichni narushenia, Psychosomatic medicine, 1993, I(1), 9–14 (in Bulgarian)
  • [18] Merdzhanov Ch., Edno komprometirano sastezanie, Sv. Kliment Ohridski, Sofia, 1995, 569 (In Bulgarian)
  • [19] Watson P., At least in the case of males: Explaining rising mortality among men in Eastern Europe, Soc. Sci. Med., 1995, 41, 923–934 http://dx.doi.org/10.1016/0277-9536(94)00405-I[Crossref]
  • [20] Shipkovenska E., Sardechno-sadow risk - problem s mnogo neizwestni, Sofia, Filvest, 2004, 152 (in Bulgarian)
  • [21] Alboni P., Alboni M., Psychosocial factors as predictors of atherosclerosis and cardiovascular events: contribution from animal models, J. Ital. Cardiol., Rome, 2006, 7, 747–753
  • [22] Kokoshkarova A., Psihologichesko izsledwane na lichnostta w klinichnata praktika, Medicina I fizkultura, Sofia, 1984, 50–56 (In Bulgarian)
  • [23] Vlahova-Nikolova V., Psihologicheska diagnostika, MU-Plovdiv, 1998, 7–9 (In Bulgarian)
  • [24] Popov Hr., Agresia I psihosomatichni narushenia, Psychosomatic medicine, 1999, VII(2), 5–12 (In Bulgarian)
  • [25] Treurniet H.F. et al., Avoidable mortality in Europe (1980–1997): a comparison of trends, J Epid. Commun. Health, 2004, 58, 290–295 http://dx.doi.org/10.1136/jech.2002.006452[Crossref]
  • [26] Stanistreet D., Jeffrev V., Injury and poisoning mortality among young men - are there any common factors amenable to prevent?, Crisis, 2003, 24, 122–127
  • [27] Melo E.C., Carvalho M.S., Travassos C., Spatial distribution of mortality from acute myocardial infarction in Rio de Janeiro, Brazil, Cad. Saude Publica, 2006, 22, 1225–1236. [Crossref]
  • [28] WHO, Monitoring trends and determinants in cardiovascular disease (MONICA), Project MONICA, Manual, CVD Unit WHO, Geneva, 1990.
  • [29] Ginzburg K., Life events and adjustment following myocardial infarction: a longitudinal Study, Soc. Psychiatry Epidemiol., 2006, 41, 825–831 http://dx.doi.org/10.1007/s00127-006-0104-9[Crossref]
  • [30] Jovanovic D., Jakovljevic B., Paunovic K., Importance of personality traits and psychosocial factors for the development of coronary heart disease, Vojnosanit Pregl., 2006, 63, 153–158. [PubMed][Crossref]
  • [31] Mitaishvili N., Danelia M., Personality type and coronary heart disease, Georg. Med. News, 2006, 134, 58–60.
  • [32] Virkkunen H., Harma M., Kauppinen T., The triad of shift work, occupational noise, and physical workload and risk of coronary heart disease,Occup. Environ. Med., 2006, 63, 378–386 http://dx.doi.org/10.1136/oem.2005.022558[Crossref]

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