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BMC Psychiatry

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Open Access 01-12-2007 | Research article

Presence of depression and anxiety before and after coronary artery bypass graft surgery and their relationship to age

Authors: Jens-Holger A Krannich, Peter Weyers, Stefan Lueger, Michael Herzog, Thomas Bohrer, Olaf Elert

Published in: BMC Psychiatry | Issue 1/2007

Abstract

Background

Scientific literature on depression and anxiety in patients with coronary heart disease (CHD) consistently reports data of elevated anxiety and depression scores indicating clinically relevant quantities of these psychopathological conditions. Depression is considered to be a risk factor for the development of CHD and deteriorates the outcome after cardiac rehabilitation efforts. The aim of our study was to evaluate the presence of clinically relevant anxiety and depression in patients before and after coronary artery bypass grafting (CABG). Additionally we evaluated their relationship to age because of the increasing number of elderly patients undergoing CABG surgery.

Methods

One hundred and forty-two consecutive patients who underwent CABG in our hospital were asked to fill in the "Hospital Anxiety and Depression Scale – German Version (HADS)" to measure depression and anxiety scores two days before and ten days after CABG surgery. Differences between these pre- and post-surgical scores were then calculated as means for changes, and the amount of elevated scores were appraised. In order to investigate the relationship between age and anxiety and depression, respectively, Spearman correlations between age and the difference scores were calculated. In addition, ANOVA procedures with the factor "age group" and McNemar tests were calculated. Therefore the sample was divided into four equally sized age groups.

Results

25.8% of the patients were clinically depressed before and 17.5% after surgery; 34.0% of the patients were clinically anxious before and 24.7% after surgery. This overall change is not significant. We found a significant negative correlation between age and the difference between the two time points for anxiety (Spearman rho = -.218; p = 0.03), but not for depression (Spearman rho = -.128; p = 0.21). ANOVA and McNemar-Tests revealed that anxiety scores and the number of patients high in anxiety declined statistically meaningful only in the youngest patient group. Such a relationship could not be found for depression.

Conclusion

Our data show a relationship between age and anxiety. Younger patients are more anxious before CABG surgery than older ones and show a decline in symptoms while elderly patients show hardly any change.

Connerney I, Shapiro PA, McLaughlin JS, Bagiella E, Sloan RP: Relation between depression after coronary artery bypass surgery and 12-month outcome: a prospective study. Lancet. 2001, 358: 1766-1771. 10.1016/S0140-6736(01)06803-9.CrossRefPubMed

Carney RM, Freedland KE, Veith RC, Jaffe AS: Can treating depression reduce mortality after an acute myocardial infarction?. Psychosom Med. 1999, 61: 666-675.CrossRefPubMed

Lavie SJ, Milani RV: Prevalence of anxiety in coronary patients with improvement following cardiac rehabilitation and exercise training. Am J Cardiol. 2004, 93: 336-339. 10.1016/j.amjcard.2003.10.015.CrossRefPubMed

Januzzi JL, Stern TA, Pasternak RC, DeSanctis RW: The influence of anxiety and depression on outcomes of patients with coronary artery disease. Arch Intern Med. 2000, 160: 1913-1921. 10.1001/archinte.160.13.1913.CrossRefPubMed

Rymaszewska J, Kiejna A, Hadryś T: Depression and anxiety in coronary artery bypass grafting patients. Eur Psychiatry. 2003, 18: 155-160. 10.1016/S0924-9338(03)00052-X.CrossRefPubMed

Jiang W, Krishnan RRK, O'Connor CM: Depression and heart disease. CNS Drugs. 2002, 16: 111-127. 10.2165/00023210-200216020-00004.CrossRefPubMed

Carney RM, Freedland KE, Miller GE, Jaffe AS: Depression as a risk factor for cardiac mortality and morbidity a review of potential mechanisms. J Psychosom Res. 2002, 53: 897-902. 10.1016/S0022-3999(02)00311-2.CrossRefPubMed

Burg MM, Benedetto MC, Rosenberg R, Soufer R: Presurgical depression predicts medical morbidity 6 months after coronary artery bypass graft surgery. Psychosom Med. 2003, 65: 111-118. 10.1097/01.PSY.0000038940.33335.09.CrossRefPubMed

Borowicz L, Royall R, Grega M, Selnes O, Lyketsos C, McKhann G: Depression and cardiac morbidity 5 years after coronary artery bypass surgery. Psychosomatics. 2002, 43: 464-471. 10.1176/appi.psy.43.6.464.CrossRefPubMed

10.

Baker RA, Andrew MJ, Schrader G, Knight JL: Preoperative depression and mortality in coronary artery bypass surgery: preliminary findings. ANZ J Surg. 2001, 71: 139-142. 10.1046/j.1440-1622.2001.02055.x.CrossRefPubMed

11.

Spertus JA, McDonell M, Woodman CL, Fihn SD: Association between depression and worse disease-specific functional status in outpatients with coronary artery disease. Am Heart J. 2000, 140: 105-110. 10.1067/mhj.2000.106600.CrossRefPubMed

12.

Mallik S, Krumholz HM, Lin ZQ, Kasl SV, Mattera JA, Roumains SA, Vaccarino V: Patients with depressive symptoms have lower health status benefits after coronary artery bypass surgery. Circulation. 2005, 111: 271-277. 10.1161/01.CIR.0000152102.29293.D7.CrossRefPubMed

13.

Ziegelstein RC, Fauerbach JA, Stevens SS, Romanelli J, Richter DP, Bush DE: Patients with depression are less likely to follow recommendations to reduce cardiac risk during recovery from a myocardial infarction. Arch Intern Med. 2000, 160: 1818-1823. 10.1001/archinte.160.12.1818.CrossRefPubMed

14.

Frasure-Smith N, Lespérance F, Gravel G, Masson A, Juneau M, Talajic M, Bourassa MG: Depression and health-care costs during the first year following myocardial infarction. J Psychosom Res. 2000, 48: 471-478. 10.1016/S0022-3999(99)00088-4.CrossRefPubMed

15.

Pignay-Demaria V, Lespérance F, Demaria RG, Frasure-Smith N, Perrault LP: Depression and anxiety and outcomes of coronary artery bypass surgery. Ann Thorac Surg. 2003, 75: 314-321. 10.1016/S0003-4975(02)04391-6.CrossRefPubMed

16.

Rozanski A, Blumenthal JA, Kaplan J: Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation. 1999, 99: 2192-2217.CrossRefPubMed

17.

Gummert JF, Funkat A, Krian A: Cardiac surgery in Germany during 2004: a report on behalf of the German society for thoracic and cardiovascular surgery. Thorac Cardiovasc Surg. 2005, 53: 391-399. 10.1055/s-2005-872933.CrossRefPubMed

18.

Geissler HJ, Hölzl P, Marohl S, Kuhn-Régnier F, Mehlhorn U, Südkamp M, de Vivie ER: Risk stratification in heart surgery: comparison of six score systems. Eur J Cardio-thoracic Sur. 2000, 17: 400-406. 10.1016/S1010-7940(00)00385-7.CrossRef

19.

Noël PH, Williams JW, Unützer J, Worchel J, Lee S, Cornell J, Katon W, Harpole LH, Hunkeler E: Depression and comorbid illness in elderly primary care patients: impact on multiple domains of health status and well-being. Ann Fam Med. 2004, 2: 555-562. 10.1370/afm.143.CrossRefPubMedPubMedCentral

20.

Jorm AF: Does old age reduce the risk of anxiety and depression? A review of epidemiological studies across the adult life span. Psychol Med. 2000, 30: 11-22. 10.1017/S0033291799001452.CrossRefPubMed

21.

Krannich J-H, Weyers P, Lueger S, Schimmer C, Faller H, Elert O: The effectiveness of a motivation program for lifestyle change in the course of coronary artery bypass graft surgery. Clin Rehabil.

22.

Hermann Ch, Buss U, Snaith RP: HADS-D, Hospital anxiety and depression scale – Deutsche Version. 1995, Bern: Hans Huber

23.

Bjelland I, Dahl AA, Haug TT, Neckelmann D: The validity of the hospital anxiety and depression scale. An updated literature review. J Psychosom Res. 2002, 52: 69-77. 10.1016/S0022-3999(01)00296-3.CrossRefPubMed

24.

Olssøn I, Mykletun A, Dahl AA: The hospital anxiety and depression rating scale: a cross-sectional study of psychometrics and case finding abilities in general practice. BMC Psychiatry. 2005, 5: 46-10.1186/1471-244X-5-46.CrossRefPubMedPubMedCentral

25.

Cossette S, Frasure-Smith N, Lespérance F: Clinical implication of a reduction in psychological distress on cardiac prognosis in patients participating in a psychosocial intervention program. Psychosom Med. 2001, 63: 257-266.CrossRefPubMed

The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-244X/7/47/prepub

Title: Presence of depression and anxiety before and after coronary artery bypass graft surgery and their relationship to age
Authors: Jens-Holger A Krannich
Peter Weyers
Stefan Lueger
Michael Herzog
Thomas Bohrer
Olaf Elert
Publication date: 01-12-2007
Publisher: BioMed Central
Published in: BMC Psychiatry / Issue 1/2007
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/1471-244X-7-47

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Presence of depression and anxiety before and after coronary artery bypass graft surgery and their relationship to age

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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