Cardiac morbidity risk and depression and anxiety: A disorder, symptom and trait analysis among cardiac surgery patients
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 = 158; 20.9% female; 11.4% concomitant valve surgery; age M = 64.7, SD = 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, ventilation >24 h, deep sternal wound
infection, reoperation, arrhythmia and 30-day mortality at any location (n = 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] = 3.26, 95% confidence interval [CI] 1.10-9.67, p = 0.03). Adjusted analysis of personality traits revealed the NA component of Type D personality was associated with cardiac morbidity (OR = 1.07, 95% CI 1.01-1.14, p = 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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Keywords:
Type D;
coronary heart disease;
generalized anxiety;
major depression;
negative affect;
panic disorder
Document Type: Research Article
Affiliations:
1:
Cardiac and Thoracic Surgical Unit, Department of Medicine, Flinders Medical Centre and Flinders University, Adelaide, South Australia, Australia,School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia,Discipline
of Psychiatry, The University of Adelaide, Adelaide, South Australia, Australia
2:
Center of Research on Psychology in Somatic diseases (CoRPS), Tilburg University, Tilburg, The Netherlands
3:
School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia,Discipline of Psychiatry, The University of Adelaide, Adelaide, South Australia, Australia
4:
Cardiac and Thoracic Surgical Unit, Department of Medicine, Flinders Medical Centre and Flinders University, Adelaide, South Australia, Australia
5:
School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
Publication date:
01 May 2011