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

RESULTS

Stress is a part of any persons 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 correlation
between 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.

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)

INTRODUCTION
Stress is a part of any persons 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.

Comparison between the frequency of defense

mechanisms at patients with somatic diseases and
affective disorder
patients with somatic conditions(cardiology and oncology)
patients with affective disorder(depression)

OBJECTIVES

12

MATERIAL AND METHODS

RESULTS

Comparison according to the level of stress between patients with somatic

conditions and affective disorder

8
1

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

Correlation between MADRS and SRRS

600
500
score SRRS

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.

intellectuai
zation

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

rationalizati
on

projection

11

repression

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

15
10
5
0

denial

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

y = 9,2015x - 3,0206
R2 = 0,3325

400
300
200
100
0

patients with somatic conditions(oncology and cardiology)

patients with affective disorder(depression)

10

20

30

40

50

60

score MADRS
13

13

14

11

12

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

10
8
5

6
4

CONCLUSIONS

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

0
without stress

minor stress

moderat stress

major stress

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

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

Comparison regarding the intensity of depression between patients

with somatic conditions and affective disorder
patients with somatic conditions (cardiology and oncology)

REFERENCES

patients with affective disorder (depression)

18
16
14
12
10
8
6
4
2
0

17
12

12
10

0
absence of depression

1
minor depression

1
moderat depression

major depression

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

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