Cardiac morbidity risk and depression and anxiety: A disorder, symptom and trait analysis among cardiac surgery patients
Date
2011
Authors
Tully, P.
Pedersen, S.
Winefield, H.
Baker, R.
Turnbull, D.
Denollet, J.
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Psychology, Health and Medicine, 2011; 16(3):333-345
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Phillip J. Tully, Susanne S. Pedersen, Helen R. Winefield, Robert A. Baker, Deborah A. Turnbull and Johan Denollet
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Abstract
The aim of this study was to examine depression and anxiety disorders and their characteristic symptoms (anhedonia/low positive affect and anxious arousal, respectively), along with measures of state negative affect (NA) and Type D personality, in relation to cardiac surgery related morbidity. Patients awaiting elective coronary artery bypass graft surgery (n ¼ 158; 20.9% female; 11.4% concomitant valve surgery; age M ¼ 64.7, SD ¼ 10.6) underwent the structured MINI International Neuropsychiatric Interview to determine current affective disorders. Patients also completed the Mood and Anxiety Symptom Questionnaire and a measure of Type D personality traits. Postoperative cardiac morbidity was confirmed after surgery during the index hospitalization and included stroke, renal failure, ventilation424 h, deep sternal wound infection, reoperation, arrhythmia and 30-day mortality at any location (n ¼ 59, 37.3% of total). After adjustment for age, recent myocardial infarction, heart failure, hypertension, urgency of surgery and time spent on cardiopulmonary bypass generalized anxiety disorder was associated with cardiac morbidity (odds ratio [OR] ¼ 3.26, 95% confidence interval [CI] 1.10–9.67, p ¼ 0.03). Adjusted analysis of personality traits revealed the NA component of Type D personality was associated with cardiac morbidity (OR ¼ 1.07, 95% CI 1.01–1.14, p ¼ 0.03). The Mood and Anxiety Symptom Questionnaire subscales were not associated with increased morbidity risk. Affective disorders, affective phenotypes, and personality traits were differentially associated with post-cardiac surgery morbidity outcomes independent of cardiac surgery morbidity risk factors. Concurrent investigation of depression and anxiety with respect to cardiac outcomes warrants further research.
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Copyright 2011 Taylor & Francis