Depressive symptomatology in coronary artery bypass graft surgery patients

• Published in: International journal of geriatric psychiatry 1999-08, Vol.14 (8), p.668-680
• Main Authors: Pirraglia, Paul A., Peterson, Janey C., Williams-Russo, Pamela, Gorkin, Larry, Charlson, Mary E.
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; coronary artery; Coronary Artery Bypass - adverse effects; Coronary Artery Bypass - psychology; coronary artery bypass graft surgery; Data processing; Demography; Depression; Depression - diagnosis; Depression - etiology; Dyspnea; Education; Female; Follow-Up Studies; Geriatrics; Heart; Humans; Intensive care units; Length of Stay; Life Change Events; Male; Medical sciences; Outcome Assessment (Health Care); outcomes; Prospective Studies; Psychiatric Status Rating Scales; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Respiration; Risk Factors; Social interactions; Social Support; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart
• ISSN: 0885-6230; 1099-1166
• DOI: 10.1002/(SICI)1099-1166(199908)14:8<668::AID-GPS988>3.0.CO;2-9

Depression is commonly reported in coronary artery bypass graft (CABG) surgery patients. This study assesses the relationship of preoperative characteristics, life stressors, social support, major cardiac and neurologic outcomes and other complications to depressive symptomatology. Demographic and clinical data, CES‐D score and information on life stressors and social support were collected from 237 patients; 92% completed 6‐month follow‐up. CES‐D score ≥16 was defined as significant depressive symptomatology. Significant depressive symptomatology was found in 43% of patients preoperatively and 23% postoperatively. In multivariate models, low social support (p=0.008), presence of at least one life stressor within a year of surgery (p=0.006), moderate to severe dyspnea (p=0.003), little to no available help (p=0.05) and less education (p=0.05) were associated with higher preoperative CES‐D score, while longer intensive care unit (ICU) stay (p=0.0001) and little or no available help (p=0.0008) predicted higher postoperative CES‐D scores when controlling for preoperative CES‐D scores. Neither pre‐ nor postoperative depressive symptomatology was related to major outcomes or other complications. A high rate of significant depressive symptomatology exists in CABG patients preoperatively, and it decreases significantly postoperatively. Patients with the above preoperative characteristics as well as those who stay in the ICU postoperatively for more than 2 days might benefit from psychosocial interventions. Copyright © 1999 John Wiley & Sons, Ltd.