Prevalence and Predictors of Psychological Disorders Following Acute Coronary Syndrome in Iraq: A Cross-Sectional Study

Objective: To determine the prevalence of psychological disorders among patients with acute coronary syndrome (ACS) in Iraq and identify sociodemographic and clinical predictors associated with these disorders, aiming to inform future psychological and medical interventions.

Methods: A descriptive cross-sectional study was conducted at the Najaf Cardiology Center from February 2023 to January 2025. The sample included 400 ACS patients aged 45–75 years. Psychological assessments were performed during hospitalization and 6–8 weeks post-discharge using validated tools: PHQ-9 (depression), GAD-7 (anxiety), and PCL-5 (PTSD). Data were analyzed with chi-square tests, Pearson correlation, and logistic regression to identify predictors.

Findings: Overall, 35% of patients experienced psychological disorders post-ACS, including depression (31%), anxiety (19%), and PTSD (11%), while 50% reported general psychological symptoms. Higher prevalence was observed in females, younger patients, and those with low socioeconomic status, poor social support, or without post-crisis psychological rehabilitation (p<0.05). Severity of cardiac event (e.g., shock, STEMI) and prior psychiatric history significantly increased the risk of psychological distress. Logistic regression confirmed low economic status, lack of social support, and high clinical severity as independent predictors.

Conclusion: Psychological disorders are common after ACS and are strongly influenced by both clinical and socioeconomic factors. Integrating routine psychological screening, early intervention, and tailored rehabilitation programs into cardiac care—particularly for high-risk groups—could improve both psychological and cardiovascular outcomes.