Anxiety and sense of coherence in Roma and non-Roma coronary heart disease patients

Objective. Morbidity and mortality among Roma due to coronary heart disease (CHD) is high, but evidence on potential psychosocial pathways is lacking. This study aimed to assess the differences in the severity of anxiety symptoms and in the sense of coherence (SOC) between Roma and non-Roma CHD patients, crude and adjusted for age, sex, functional status and socio-economic status (SES).

Design. We examined 607 CHD patients (mean age 58.0 +/- 7.4, 28.7% female) scheduled for coronary angiography, 98 (16.1%) of whom were Roma. Anxiety symptoms were measured using the Hospital Anxiety and Depression Scale and SOC using the 13-item Orientation to Life Questionnaire. Data were analysed using hierarchical regression.

Results. Roma ethnicity was associated with more severe anxiety (B = 1.89; [95% confidence interval (CI) = 0.79; 2.98]) adjusted for age, sex, functional status and SES. Roma ethnicity was also associated with lower SOC (B = -4.77; [ 95% CI = -7.85; -1.68]) adjusted for age, sex and functional status. The latter association lost statistical significance after adjustment for SES.

Conclusion. Roma ethnicity is associated with more anxiety symptoms and lower SOC among CHD patients. Our findings indicate that Roma CHD patients have a worse position regarding psychosocial factors that increase mortality and thus require additional attention.