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[Evaluation of preoperative anxiety and depression in patients undergoing invasive cardiac procedures]
Antonio Fernando Carneiro1, Ligia Andrade S Telles Mathias, Anis Rassi Júnior
1Universidade Federal de Goiás.
Insights
Patients with cardiac disease undergoing procedures like electrophysiological studies, pacemaker implantation, or myocardial revascularization experience varying anxiety levels. However, depression levels remain consistent across these cardiac patient groups.
Area of Science:
- Cardiology
- Psychiatry
- Medical Psychology
Context:
- Routine preoperative evaluations often overlook anxiety and depression in cardiac patients.
- Cardiac conditions can significantly impact a patient's emotional state, potentially masking or exacerbating these disorders.
- The Hospital Anxiety and Depression Scale (HAD) is a validated tool for assessing emotional status.
Purpose:
- To compare the prevalence and severity of anxiety and depression in cardiac patients undergoing different invasive procedures.
- To investigate if the type of cardiac intervention correlates with distinct emotional distress levels.
Summary:
- 96 patients with cardiac diseases (ASA II-III) were categorized into three groups: electrophysiological study (EPS), pacemaker (PM) placement, and myocardial revascularization (MR).
- Anxiety levels (HAD-A) and prevalence differed significantly among the groups (p=0.006), particularly between EPS vs. MR and EPS vs. PM (p<0.05).
- No statistically significant differences were found in depression levels (HAD-D) among the patient groups.
Impact:
- Highlights the need for tailored psychological assessments in cardiac patients undergoing specific procedures.
- Suggests that anxiety management strategies may need to be procedure-specific for cardiac patients.
- Underscores that depression assessment may not require differentiation based on the type of cardiac intervention.
Background And Objectives:
Specific assessment of anxiety and depression is not included in routine preoperative evaluation; therefore, in cases of cardiac diseases in which the emotional status of the patient may be modified by the disease those disorders may not be diagnosed. The objective of the present study was to compare the level and prevalence of anxiety and depression in patients with cardiac disease undergoing invasive and/or surgical procedures using the Hospital Anxiety and Depression Scale - HAD.
Methods:
After approval by the Ethics Committee, 96 patients, physical status ASA II and III, were divided in three groups: electrophysiological study (EPS), pacemaker (PM) placement, and myocardial revascularization (MR). 'Cutting points' were as follows: HAD-anxiety scale (HAD-A) with anxiety > 9; HAD-depression scale (HAD-D) with depression > 9.
Results:
All three groups were homogenous regarding sociodemographic parameters. Statistically significant differences were observed among the three groups (p = 0.006; p = 0.034) in the level and prevalence of anxiety (HAD-A); and in the intergroup comparison of the anxiety level significant differences were observed between the EPS x MR and EPS x PM groups (p < 0.05). Significant differences in the level and prevalence of depression (HAD-D) among the study groups were not observed.
Conclusions:
Patients with cardiac diseases undergoing electrophysiological studies, pacemaker implantation, and myocardial revascularization have different levels and prevalence of anxiety, but they do not show differences in the level and prevalence of depression.
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