Psychological disorders after coronary artery by-pass surgery: a one-year prospective study

Abstract

Background: Coronary artery by-pass surgery (CABG) is often followed by anxiety and depression that require early identification in order to provide adequate psychological support. The predictive role of tests administered soon after CABG on long-term psychological outcomes has been only incompletely explored. Aim, Design and Methods: Aim of this study was to assess post-operative and 12-month persistence of psychological disorders by means of the Minnesota Multiphasic Personality Inventory (MMPI-2) and the depression and state and trait anxiety scales of the Cognitive Behavioural Assessment (CBA-2.0) in 118 male patients admitted to cardiac rehabilitation after CABG. Results: Early after CABG we observed a high prevalence of depression (11.8% by MMPI-2 and 12.7% by CBA) and state anxiety (23.5%). At 1-year the MMPI-2 scale D indicated stable mean score and high scores at entry were predictive of persistent depression. Conversely the CBA-2.0 scale QD score significantly decreased (from 3.86±3.19 to 2.91±3.45, p=0.017). Also ST1 state anxiety significantly decreased (from 35.17±6.95 to 32.55±6.72, p=0.003) whereas ST2 trait anxiety was stable. We found no association between psychometric results and ventricular function, number of grafts or time since diagnosis of coronary artery disease. Conclusions: State anxiety and depression by CBA significantly decreased 1-year after CABG; conversely trait anxiety and depression, investigated by MMPI-2, a more specific personality questionnaire, were stable. High scores for the depression in the scale D of MMPI-2 early after CABG seem to be predictive of the persistence of the disorder at 1-year.

Keywords

• anxiety
• coronary artery by-pass surgery
• depression
• psychological disorders