The impact of pain and depression on recovery after coronary artery bypass grafting

• Published in: Psychosomatic medicine 2010-09, Vol.72 (7), p.620-625
• Main Authors: Morone, Natalia E, Weiner, Debra K, Belnap, Bea Herbeck, Karp, Jordan F, Mazumdar, Sati, Houck, Patricia R, He, Fanyin, Rollman, Bruce L
• Format: Article
• Language: English
• Subjects: Aged; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Clinical trials; Comorbidity; Coronary Artery Bypass - psychology; Depressive Disorder - diagnosis; Depressive Disorder - drug therapy; Depressive Disorder - epidemiology; Female; Health care; Health Status; Humans; Male; Mental depression; Middle Aged; Outcome Assessment (Health Care); Pain; Pain - diagnosis; Pain - drug therapy; Pain - epidemiology; Pain Measurement - statistics & numerical data; Pain, Postoperative - diagnosis; Pain, Postoperative - drug therapy; Pain, Postoperative - epidemiology; Patient Care Team; Patients; Postoperative Complications - drug therapy; Postoperative Complications - epidemiology; Surveys and Questionnaires; Treatment Outcome
• ISSN: 0033-3174; 1534-7796
• DOI: 10.1097/PSY.0b013e3181e6df90

To describe the relationship between pain and depression on recovery after coronary artery bypass grafting (CABG). A secondary data analysis on 453 depressed and nondepressed post-CABG patients enrolled in a randomized, controlled, effectiveness trial of telephone-delivered collaborative care for depression. Outcome measures were collected from March 2004 to September 2007 and included pain, physical function, and mood symptoms. Depressed patients (baseline Patient Health Questionnaire-9 score ≥10) versus those without depression reported significantly worse pain scores on the 36-Item Short Form Health Survey Bodily Pain Scale at baseline and up to 12 months post-CABG, p < .05. Among patients with depression, those who received collaborative care reported significantly better pain scores at each time point between 2 and 12 months post-CABG versus depressed patients randomized to the usual care control group, p < .05. Regardless of intervention status, depressed participants with at least moderate pain at baseline reported significantly lower functional status (measured by the Duke Activity Status Index) at 8 and 12 months versus depressed patients with none or mild pain, p < .05. Depressed patients with at least moderate pain at baseline were also significantly less likely to show improvement of depressive symptoms throughout the course of follow-up versus depressed patients with little or no pain, p < .05. These findings controlled for age, gender, education, race, comorbid conditions, and baseline pain diagnosis. Depression and pain seem to influence functional recovery post-CABG. The relationship between these two conditions and 12-month outcomes should be considered by clinicians when planning treatment.