Homocysteine level and depression in patients with ischaemic heart disease

Mohamed Nashaat¹, Emad Hamdi¹, Shereen Mohamed Abdel Mawella¹, Dalal Amer¹, Aref Khoweiled¹, Hoda Abdou¹, Amal Abdou^2
1 Department of Psychiatry, Faculty of Medicine, Cairo University, Giza, Egypt
² Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Giza, Egypt

Correspondence Address:
Shereen Mohamed Abdel Mawella
Department of Psychiatry, Faculty of Medicine, Cairo University, Giza
Egypt

Source of Support: None, Conflict of Interest: None

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DOI: 10.7123/01.EJP.0000413550.34072.a4

High levels of homocysteine are associated with vascular disease, changes in the levels of monoamine neurotransmitters and depression. A plausible hypothesis for these associations is that high homocysteine levels are implicated in vascular disease and neurotransmitter deficiency, which are in turn linked to depression.

To investigate the association between elevated homocysteine levels and depressive symptoms in patients with ischaemic heart disease (IHD).

Eighty patients with a confirmed diagnosis of IHD were consecutively selected in a cross-sectional study from the inpatient and outpatient cardiology department of Kasr-Al-Ainy hospital. All IHD patients were diagnosed according to the criteria of the American College of Cardiology. Depression was evaluated using the Present State Examination-10 Short English–Arabic Version and the Beck Depressive Inventory. The serum level of homocysteine was determined using the chemiluminescent technique.

Thirty-six ischaemic heart patients (45%) had depressive disorders. Depressed patients were older and had a longer duration of the IHD. The level of homocysteine was higher in depressed patients (P=0.098). Positive correlations were found between age and the serum level of homocysteine (P=0.028) but no correlations were found between the serum level of homocysteine and the severity of depression. Sleep disturbances correlated significantly with homocysteine levels irrespective of age.

Depressive symptoms are common in IHD patients, especially patients with prolonged duration of the disease. They are more apparent in IHD patients at times of emergency and intervention. In IHD patients, the serum level of homocysteine is associated with the occurrence of vegetative depressive symptoms.