Depression following cardiac surgery is more common than appreciated and can adversely impact length of stay, recovery, and quality of life. The purpose of this study was to identify those at increased risk of developing post-operative depression and to intervene early to decrease the mortality and morbidity associated with post-operative depression. This study prospectively analyzed various patient characteristics, socio-economic factors, and fatalism to determine their relationship to post-operative depression. If a correlation was identified, then pre-operative intervention could be initiated to mitigate the adverse effects of depression on recovery.
Consecutive patients scheduled for coronary bypass or valve surgery were screened for inclusion in the study. Patients under the age of 40, those with pre-existing depression, and patients needing reoperation were excluded. One hundred twenty-five patients who met criteria were followed over a 12-week period. Baseline data relating to heart surgery (Euroscore), socio-economic demographics, depression score (PHQ9), and a fatalism scale were collected. Follow-up assessments for depression occurred at 6 weeks and at 12 weeks post-surgery. Data were collected by chart review and direct face-to-face interviews, and were analyzed utilizing SAS software.
Eighty-four men and 41 women met the inclusion criteria. One hundred fourteen (91%) completed follow-up at 6 weeks, and 105 (84%) completed the follow-up at 12 weeks. The mean fatalism score was 49.4 (22-88), and the mean depression score was 4.0(0-11). Fatalism, Euroscore, baseline PHQ-9 score, gender, race, marital status, education level, church membership, and diabetes explained 22% of the variability in PHQ-9 scores at both 6 and 12 weeks. However, this was not significant (p=> 0.05).
Fatalism was found to be associated with depression, but socio-demographic factors explained more variability in depression at 6 weeks and 12 weeks. Further studies to identify other determinants of postoperative depression are warranted. The results suggest that pre-operative interventions to limit subsequent depression should be explored.
|Advisor:||Allegrante, John P., Marks, Ray|
|Commitee:||Fraga, Elizabeth, Miville, Marie|
|School:||Teachers College, Columbia University|
|Department:||Health and Behavior Studies|
|School Location:||United States -- New York|
|Source:||DAI-B 76/10(E), Dissertation Abstracts International|
|Subjects:||Mental health, Behavioral psychology, Surgery, Demography|
|Keywords:||Cardiac surgery, Depression, Fatalism|
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