Gender-Based Distribution of Depression and Anxiety Following Acute Coronary Syndrome in the Turkish Population: Are Women at Higher Risk

Abstract

Background Depression and anxiety are common psychological disorders following acute coronary syndrome (ACS), potentially affecting patient outcomes. Sex-based disparities in the prevalence of these disorders may significantly impact recovery and rehabilitation post-ACS. Aims To evaluate gender-based differences in depression and anxiety prevalence among Turkish patients following (ACS), and to identify sociodemographic and clinical factors associated with psychological distress. Methods In this cross-sectional observational study, 604 patients (144 women and 460 men) diagnosed with ACS were enrolled at their initial outpatient follow-up (4-8 weeks post-discharge). Data collection included demographic and clinical surveys along with the Hospital Anxiety and Depression Scale (HADS). Results Depression and anxiety were significantly more prevalent in women than men (61.1% vs. 37.4% for depression, p < 0.001; 30.6% vs. 20.0% for anxiety, p = 0.008). Moderate-to-severe symptoms were also more common among women for both conditions (p < 0.001). Lower education levels and income below expenses were associated with higher anxiety and depression scores (p < 0.025). Among women, married individuals reported higher anxiety than widowed/divorced women (p < 0.001). Hypertension significantly increased distress, particularly in men (p < 0.001), while chronic kidney disease had a stronger impact among women (p < 0.018). Conclusion There are marked gender disparities in depression and anxiety prevalence post-ACS, with women being significantly more affected. Socioeconomic disadvantages and comorbid conditions contribute to psychological distress. Routine psychological screening and sex-sensitive interventions, especially for vulnerable groups, are crucial for improving outcomes after ACS. Significant gender disparities exist in post-ACS depression and anxiety, with women disproportionately affected. Socioeconomic disadvantage and comorbidities further compound psychological distress. Integrating routine mental health screening and sex-sensitive interventions into post-ACS care is essential, particularly for high-risk populations, to improve long-term outcomes.