Changes in Anxiety and Depression in Patients with an Acute Myocardial Infarction that Received Treatment by
Tomoaki Hama1, Kaho Hashimoto2, Tadahiro Goto3,4
1Division of Cardiology, Department of Medicine, Tokai University Hachioji Hospital, Tokyo, Japan.
Insights
Mental health in acute myocardial infarction (AMI) patients improved with the ABCDEFGH bundle. Anxiety scores decreased, but depression persisted post-discharge, affecting 34% of patients.
Area of Science:
- Cardiology
- Psychiatry
- Health Services Research
Background:
- Mental health disorders like anxiety and depression are common in acute myocardial infarction (AMI) patients.
- The effectiveness of specific treatments for these conditions in AMI patients remains unclear.
- The ABCDEFGH bundle, incorporating continuous nurse-led follow-up, is a comprehensive approach to patient care.
Purpose of the Study:
- To evaluate changes in anxiety and depression over time in AMI patients treated with the ABCDEFGH bundle.
- To determine the post-discharge prevalence of anxiety and depression in these patients.
- To assess the impact of percutaneous coronary intervention (PCI) and the ABCDEFGH bundle on mental health outcomes.
Main Methods:
- A retrospective cohort study of 29 AMI patients who underwent PCI and received ABCDEFGH bundle treatment.
- Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS) in the ICU, general ward, and outpatient department (OPD).
- Statistical analysis compared HADS scores across different care phases and determined post-discharge prevalence.
Main Results:
- Anxiety scores (HADS-A) significantly improved from ICU to OPD (6.4 to 3.9, p=0.001).
- Depression scores (HADS-D) showed no significant changes between ICU, general ward, and OPD (ranging from 5.2 to 6.7).
- Post-discharge, 14% of patients experienced anxiety and 34% experienced depression.
Conclusions:
- The ABCDEFGH bundle treatment, including PCI, led to improved anxiety levels in AMI patients.
- Depression remained a significant issue, with a high prevalence post-discharge, indicating a need for targeted interventions.
- Continuous follow-up and comprehensive care bundles may help manage anxiety but require further investigation for depression in AMI survivors.
Introduction:
It remains unclear which treatments are effective for addressing mental disorders in patients with acute myocardial infarction (AMI). Therefore, we evaluated the changes over time in anxiety and depression from intensive care units (ICUs) to outpatient departments (OPDs), as well as the post-discharge prevalence of anxiety and depression in AMI patients who underwent percutaneous coronary intervention (PCI) and received treatments based on the ABCDEFGH bundle, including nurse-led continuous follow-up.
Methods:
This retrospective cohort study involved 29 patients who were hospitalized in the ICU for treatment of AMI. All patients received PCI and treatment based on the ABCDEFGH bundle. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS) at three phases: ICU, general ward (GW), and OPD. First, we compared changes in anxiety and depression scores over time using HADS across the three phases. Second, we assessed the prevalence rate of anxiety and depression after hospital discharge based on HADS scores.
Results:
Of the 29 patients, the mean age was 67 ± 14 years, and 66% were male. For the anxiety subscale (HADS-A), scores improved from ICUs to OPDs (6.4-3.9 points, p = 0.001). For the depression subscale (HADS-D), there were no significant changes between ICU and GW, or between ICU and OPD (5.4-6.7, 5.4-5.2 points, respectively; all not significant). At the OPD stage, 14% of patients were in an anxiety state, and 34% were in a depression state.
Conclusions:
In AMI patients who received PCI and treatments based on the ABCDEFGH bundle, the depression state remained unchanged from ICUs to OPDs, while the anxiety state improved after hospital discharge. The prevalence of anxiety was 14%, and the prevalence of depression was 34% after hospital discharge.
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