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Depresión y ansiedad en pacientes con derivación aortocoronaria

Published online by Cambridge University Press:  12 May 2020

Joanna Rymaszewska ,
Andrzej Kiejna  and
Tomasz Hadry's
Joanna Rymaszewska
Affiliation:
Departamento de Psiquiatría, Universidad Médica, Pasteura 10, 50-367Wroclaw, Polonia
Andrzej Kiejna
Affiliation:
Departamento de Psiquiatría, Universidad Médica, Pasteura 10, 50-367Wroclaw, Polonia
Tomasz Hadry's
Affiliation:
Departamento de Psiquiatría, Universidad Médica, Pasteura 10, 50-367Wroclaw, Polonia
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Resumen

Propósito

La cirugía cardíaca es un factor que provoca respuestas emocionales y fisiológicas específicas de un paciente. A pesar de los efectos somáticos positivos de la cirugía, la depresión y la ansiedad pueden persistir o aparecer por primera vez después de la intervención quirúrgica, empeorando el funcionamiento psicosocial y la calidad de vida del paciente. El propósito de este estudio es ofrecer una visión prospectiva sobre la incidencia y el curso de los autoinformes de depresión y ansiedad en pacientes con derivación aortocoronaria (DAC).

Sujetos y métodos

Después del consentimiento informado, 53 pacientes que se propusieron para DAC fueron examinados unos días antes y después de la intervención y 3 meses después de ella. Los pacientes rellenaron el Cuestionario de Ansiedad de Spielberger y el Inventario de Depresión de Beck.

Resultados

El 55% aproximadamente de los pacientes tenía un nivel alto de ansiedad preoperatoria. Poco después de la intervención, el 34% de los pacientes y, después de 3 meses, el 32% de ellos tenían un nivel clínicamente relevante de ansiedad. El 32% de los pacientes antes de la intervención, el 28% inmediatamente después de la DAC y el 26% en el seguimiento estaban deprimidos.

Conclusiones

Las puntuaciones preoperatorias altas de depresión, ansiedad como estado y ansiedad como rasgo parecen ser predictoras de la evolución psicológica posoperatoria. La evaluación preoperatoria puede identificar a los pacientes con riesgo de niveles clínicos de ansiedad y depresión posoperatorias. El consejo preventivo psicológico y la intervención psiquiátrica pueden reducir el sufrimiento emocional de los pacientes, y los costes médicos y los económicos.

Keywords

DepresiónAnsiedadDerivación Aortocoronaria (DAC)
Type
Original
Information
European Psychiatry (Ed. Española) , Volume 10 , Issue 7 , October 2003 , pp. 438 - 445
Copyright
Copyright © European Psychiatric Association 2003

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References

Bibliografía

Ai, AL, Dunkle, RE, Peterson, C, Saunders, DG, Bolling, SF, Buchtel, HA.How gender affects psychological adjustment one year after coronary artery bypass graft surgery? Women Health 1997; 26: 45–65.CrossRefGoogle ScholarPubMed
Artínian, NT, Duggan, CH, Miller, P.Age différences in patients1 recovery patterns following coronary artery bypass surgery. Am J Crit Care 1993; 2: 453–61.CrossRefGoogle Scholar
Artinian, NT, Duggan, CH.Sex differences in patients' recovery patterns after coronary artery bypass surgery. Heart Lung 1995; 24: 483–94.CrossRefGoogle Scholar
Borowicz, LM, Goldsborough, MA, Selnes, OA, Enger, C, McKhann, GM.Depression, morbidity and hospital length of stay after coronary artery bypass grafting. Outcomes '99, Conference on Cardiac and Vascular Surgery: Neurobehavioral Assessment, Physiological Monitoring and Cerebral Protective Strategies. Ann Thorac Surg 1999; 68: 1458–67.Google Scholar
Boudrez, H, Denollet, BJ, Amsel, G, De Backer, G, Walter, PJ, De Beule, J, et al.Psychological status of patients before and after coronary artery bypass surgery. In: Walter, PJ, editor. Quality of life after open heart surgery. Dordrecht: Kluwer Academic Publishers; 1992.CrossRefGoogle Scholar
Brezinka, V, Kittel, F.Psychosocial factors of coronary heart disease in women: a review. Soc Sci Med 1996; 42: 1351–65.CrossRefGoogle ScholarPubMed
Burker, EJ, Blumenthal, JA, Feldman, M.Depression in male and female patients undergoing cardiac surgery. Br J Clin Psychol 1995; 34: 119–28 (Pt 1).CrossRefGoogle ScholarPubMed
Cay, E.The emotional state of patients after coronary bypass surgery. In: Walter, PJ, editor. Quality of life after open heart surgery. Dordrecht: Kluwer Academic Publishers; 1992, 177–85.CrossRefGoogle Scholar
Con, AH, Linden, W, Thompson, JM, Ignaszewski, A.The psychology of men and women recovering from coronary artery bypass surgery. J Cardiopulm Rehabil 1999; 19: 152–61.CrossRefGoogle ScholarPubMed
Czajkowski, SM, Terrin, M, Lindquist, R, Hoogwerf, B, Dupuis, G, et al.Comparison of preoperative characteristics of men and women undergoing coronary artery bypass grafting (the post coronary artery bypass graft [CABG] biobehavioural study). Am J Cardiol 1997; 79: 1017–24.CrossRefGoogle Scholar
Duits, AA, Duivenvoorden, HJ, Boeke, S, Taams, MA, Mochtar, B, Krauss, XH, et al.A structural modeling analysis of anxiety and depression in patients undergoing artery bypass graft surgery: a model generating approach. J Psychosom Res 1999; 46: 187–200.CrossRefGoogle ScholarPubMed
Folks, DG.Cognitive dysfunction after coronary artery bypass surgery: a cased controlled study. South Med J 1988; 81: 202–6.CrossRefGoogle Scholar
Heijmeriks, JA, Pourrier, S, Dassen, P, Prenger, K, Wellens, HJJ. Comparison of quality of life after coronary and/or valvular cardiac surgery in patients >75 years of age with younger patients. Am J Cardiol 1999; 83: 1129–32.CrossRefGoogle ScholarPubMed
Horgan, D, Davies, B, Hunt, D, Westlake, GW, Mullerworth, M.Psychiatric aspects of coronary artery surgery. A prospectíve study. Med J Aust 1984; 141: 587–90.CrossRefGoogle ScholarPubMed
Jodzio, K.Psychosocial problems of patients after surgical treatment of coronary artery disease. Sztuka Leczenia 1996; 2: 41–6.Google Scholar
Langeluddecke, PM.A prospective evaluation of the psychological effects of coronary artery bypass surgery. J Psychosom Res 1989; 33: 37–45.CrossRefGoogle ScholarPubMed
Magni, G.Psychosocial outcome one year after heart surgery: a prospective study. Arch Intern Med 1987; 147: 473–7.CrossRefGoogle ScholarPubMed
Mahler, HI, Kulik, JA, Tarazi, RY.Effects of a videotape information intervention at discharge on diet and exercise compliance after coronary bypass surgery. J Cardiopulm Rehabil 1999; 19: 170–7.CrossRefGoogle ScholarPubMed
McKhann, GM.Depression and cognitive decline after artery bypass grafting. Lancet 1997; 49: 1282–4.CrossRefGoogle Scholar
McKhann, GM, Goldsborough, MA, Borowicz, LM, et al.Cognitive outcome after coronary artery bypass: a one-year prospective study. Ann Thorac Surg 1997; 63: 510–5.CrossRefGoogle ScholarPubMed
Moore, SM.A comparison of women's and men's symptoms during home recovery after coronary artery bypass Surgery. Heart Lung 1995; 24: 495–501.CrossRefGoogle ScholarPubMed
Perski, A, Osuchowski, K, Andersson, L, Sanden, A, Feleke, E, Anderson, G.Intensive rehabilitation of emotionally distressed patients after coronary by-pass grafting. J Intern Med 1999; 246: 253–63.CrossRefGoogle ScholarPubMed
Peterson, JC. Longitudinal course of new onset depression after cardiac bypass surgery Programs and Abstracts of the 10th Annual International Conference on Mental Health Problems in the General Health Care Sector, National Institute of Mental Health Bethesda, MD. July 15-16, 1996.Google Scholar
Pimm, JB, Jude, JR.Beck depression inventory scores of coronary patients with or without psychological inter ventions. In: Willner, AE, Rodewald, G, editors. Impact of cardiac surgeryon the quality of life. New York: Plenum Press; 1990.Google Scholar
Pirraglia, PA, Peterson, JC, Williams-Russo, P, Gorkin, L, Charlson, ME.Depressive symptomatology in coronary artery bypass graft surgery patients. Int J Geriatr Psych 1999; 14: 668–80.3.0.CO;2-9>CrossRefGoogle ScholarPubMed
Redeker, NS.Symptoms reported by older and middle-aged adults after coronary bypass surgery. Clin Nurs Res 1993; 2: 148–59.CrossRefGoogle ScholarPubMed
Regragui, I, Birdi, I, Izzat, MB, Black, AMS, Lopatatzidis, A, Day, CJE, et al.The effect of cardiopulmonary bypass temperature on neuropsychologic outcome after coronary artery operations: a prospective randomized trial. J Thorac Cardiovasc Surg 1996; 112: 1036–45.CrossRefGoogle ScholarPubMed
Scheier, MF, Matthews, KA, Owens, JF, Schulz, R, Bridges, MW, Magoverng, GJ, et al.Optimism and rehospitalization after coronary artery bypass graft surgery. Arch Intern Med 1999; 159: 829–35.CrossRefGoogle ScholarPubMed
Strauss, B.Preoperative and late postoperative psychosocial State following CABG surgery. J Thorac Cardiovasc Surg 1992; 40: 59–64.CrossRefGoogle Scholar
Timberlake, N.Incidence and patterns of depression following coronary artery bypass surgery. J Psychosom Res 1997; 2: 197–207.CrossRefGoogle Scholar
Vingerhoets, G.Perioperative anxiety and depression in open-heart surgery. Psychosomatics 1998; 39: 30–7.CrossRefGoogle ScholarPubMed
Vingerhoets, G, Van, Nooten G, Vermassen, F, De Soete, G, Jannes, C.Short-term and long-term neuropsychological consequences of cardiac surgery with extracorporeal circulation. Eur J Cardiothorac Surg 1997; 11: 424–31.CrossRefGoogle ScholarPubMed
Westin, L, Carlsson, R, Erhardt, L, Cantor-Graae, E, McNeil, T.Differences in quality of life in men and women with ischaemic heart disease. A prospective controlled study. Scand Cardiovasc J 1999; 33: 160–5.Google ScholarPubMed