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Coronary heart disease: surgery

from Medical topics

Published online by Cambridge University Press:  18 December 2014

By
Jan Stygall  and
Stanton Newman
Edited by
Susan Ayers ,
Andrew Baum ,
Chris McManus ,
Stanton Newman ,
Kenneth Wallston ,
John Weinman  and
Robert West
Jan Stygall
Affiliation:
University College London
Stanton Newman
Affiliation:
University College London
Susan Ayers
Affiliation:
University of Sussex
Andrew Baum
Affiliation:
University of Pittsburgh
Chris McManus
Affiliation:
St Mary's Hospital Medical School
Stanton Newman
Affiliation:
University College and Middlesex School of Medicine
Kenneth Wallston
Affiliation:
Vanderbilt University School of Nursing
John Weinman
Affiliation:
United Medical and Dental Schools of Guy's and St Thomas's
Robert West
Affiliation:
St George's Hospital Medical School, University of London
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Summary

Psychological responses to cardiac surgery

It has been suggested that a relatively high level of psychological morbidity follows cardiac surgery in contrast to other forms of surgery. However this view has not been borne out in formal research. Studies of general psychiatric morbidity, using standardized instruments, have shown a general reduction following cardiac surgery. Studies have also demonstrated that patterns of anxiety are similar to those found in other forms of surgery with a significant increase in anxiety in the days immediately before and after surgery followed by a significant drop in the weeks and months following surgery (Rymaszewska et al., 2003). The prevalence of depression has been found to be the same before and after cardiac surgery, in the range of approximately 20–25% (Connerney et al., 2001). Furthermore, studies have shown no differences in the emotional effects of either coronary bypass graft (CABG) surgery or valve replacement/repair (see also ‘Stressful medical procedures’ and ‘Surgery’).

Both anxiety and depression have been shown to predict adverse outcomes post-cardiac surgery (e.g. Connerney et al., 2001; Rymaszewska et al., 2003). Whereas early small studies (e.g. Connerney et al., 2001) failed to find a relationship between depression and mortality after cardiac surgery, a large 12-year follow-up study by Blumenthal et al. (2003) found depression to be an important independent predictor of mortality.

It is not surprising that the most potent predictor of mood state after cardiac surgery is mood prior to surgery.

Type
Chapter
Information
Cambridge Handbook of Psychology, Health and Medicine , pp. 659 - 662
Publisher: Cambridge University Press
Print publication year: 2007

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References

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