Phenomenological analysis of depressive and anxious manifestations in patients who underwent cardiosurgery

Abstract

Among the undeniable advantages of surgical tactics in the treatment of patients with various forms of cardiovascular disease, there are problematic issues, including neurological complications, especially cerebrovascular disorders and postoperative encephalopathy, and often associated psychopathological disorders based on postoperative hypoxiс-ischemic lesions, which remain one of the most difficult and dangerous complications of operations under the conditions of artificial circulation (AC). The aim was to carry out clinical and phenomenological analysis of psychopathological manifestations of depression and anxiety in patients who underwent cardiac surgery (CS) with AC in the postoperative period, both in general and in terms of individual types of vascular and neurological pathology, to determine further directions of their rehabilitation. Material and research methods. Using the approach of a structured clinical-diagnostic interview with the help of a specially developed questionnaire, we clinically examined 700 patients who were treated at the Heart Institute of the Ministry of Health of Ukraine and who underwent CS under the conditions of AC. Among the examined patients, there were 86 patients (12.3%) with cerebral infarction (CI), 217 patients (31.0%) with the signs of postoperative encephalopathy and 504 patients (72.0%) with manifestations of cognitive dysfunction. Results. It has been established that patients who underwent cardiac surgery had the symptoms of depression and anxiety. The most severe depressive and anxiety manifestations are characteristic of patients with cerebral infarction in the postoperative period of cardiac surgery; they are less significant in patients with signs of postoperative encephalopathy. They are the least significant in patients with signs of cognitive dysfunction. At the same time, the severity of depressive and anxiety phenomena in patients with this pathology was significantly (p<0.01) higher than in patients who underwent cardiac surgery without the corresponding pathology. Conclusion. The identified patterns should be considered when developing treatment, rehabilitation and preventive measures for patients who underwent cardiac surgery with postoperative neurological complications.

Keywords

• cardiac surgery under the conditions of artificial blood circulation
• anxiety
• depression
• neurological complications