[Two cases of depressive disorder after pacemaker implantation]

Area of Science:

• Cardiology
• Psychiatry
• Psychology

Background:

• Pacemaker implantation can lead to psychological distress, including depressive disorders.
• Pacemaker syndrome was excluded in these cases, suggesting other psychological mechanisms at play.

Observation:

• Two patients experienced psychological symptoms post-pacemaker implantation, including fatigue and unaccountable sensations.
• Symptoms improved with acceptance of bodily dependence on the pacemaker and symbiosis with it as 'not-self'.
• Patient 2's symptoms improved with 'mourning for the loss of the perfection of the own body'.

Findings:

• The psychological process involves mourning the loss of bodily perfection and establishing symbiosis with the pacemaker as 'not-self'.
• Impairment in this process can lead to depressive symptoms.
• This adjustment process is comparable to integration in patients undergoing dialysis or renal transplantation.

Implications:

• Achieving 'symbiosis with the pacemaker' may be more beneficial than complete integration for patient adjustment.
• Understanding this psychological process is crucial for providing effective support and reducing depression post-pacemaker implantation.
• Further research into psychological support strategies for pacemaker recipients is warranted.