Clinical depression in women after cardiac surgery

After coronary artery bypass graft (CABG), women are particularly vulnerable to depression because they are more socially isolated and are more likely to have preoperative mood disorders than men. The purpose of this study was to (1) describe the incidence and course of clinical depression in women during the first 6 months after CABG; (2) describe the frequency of depressive symptoms after CABG in women; and (3) identify factors associated with post-CABG depression in women.

Before hospital discharge, 75 women undergoing CABG for the first time participated in a semistructured interview to determine the presence of major or minor depression using the Diagnostic and Statistical Manual, Fourth Edition, criteria. In 55 women, additional interviews were conducted within the first month and at 6 months after discharge. Data were evaluated using frequencies, analysis of variance, Mann-Whitney U test, and logistic regression.

Clinical depression occurred before hospital discharge, in the first month after discharge, and 6 months after discharge in 30.9%, 16.4%, and 12.8%, respectively, of the women who completed a 6-month follow-up. Younger women, those with more perioperative complications, and those with a history of depression were at greater risk for clinical depression. After hospital discharge, the occurrence of any clinical depression within the first month was associated with an increased occurrence of clinical depression 6 months later. Younger women, those with more perioperative complications and early depressive symptoms, and those with persistent occurrence of the most commonly reported symptoms (anhedonia, dysphoria, and fatigue) should be carefully evaluated.