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Psychopathology following cardioverter defibrillator implantation
S J Crow1, J Collins, M Justic
1Department of Psychiatry, University of Minnesota, Minneapolis 55455, USA.
Insights
Implantable cardioverter defibrillator (ICD) recipients show similar psychopathology rates to the general population initially. New mental health issues post-implantation are rare and primarily affect individuals with prior mental health history.
Area of Science:
- Cardiology
- Psychiatry
- Medical Devices
Background:
- Previous research indicates elevated psychopathology rates in implantable cardioverter defibrillator (ICD) recipients.
- Understanding the psychological impact of ICDs is crucial for comprehensive patient care.
Purpose of the Study:
- To assess the prevalence and incidence of psychopathology in ICD recipients.
- To determine if ICD implantation is associated with new-onset mental health disorders over time.
Main Methods:
- Thirty-five consecutive ICD recipients underwent psychiatric assessment using the Structured Clinical Interview for DSM-III-R and a questionnaire.
- Assessments were conducted within 3 days of ICD implantation (Time 1) and 9-18 months later (Time 2).
Main Results:
- At Time 1, alcohol dependence in remission was the most common diagnosis, followed by mood disorders.
- Only two new cases of depression were identified at Time 2, both in patients with a prior history of depression or depressive symptoms.
- No new anxiety disorders were observed at follow-up.
Conclusions:
- ICD recipients exhibit psychopathology rates comparable to the general population at the time of implantation.
- The risk of developing new psychopathology after ICD implantation is minimal and primarily associated with pre-existing mental health conditions.
Abstract:
Previous reports have found elevated rates of psychopathology in recipients of implantable cardioverter defibrillators (ICDs). Thirty-five consecutive ICD recipients were assessed by using the Structured Clinical Interview for DSM-III-R and a semistructured questionnaire; assessments were performed within 3 days of ICD implantation (Time 1) and again 9-18 months later (Time 2). At the initial assessment, alcohol dependence in remission was the most common diagnosis, followed by mood disorders. Two cases of depression were found at follow-up assessment, but those subjects had either a lifetime history of major depression or some depressive symptoms at Time 1. No new cases of anxiety disorders were seen at Time 2. It appears that ICD recipients have rates similar to the general population at the time of implantation, and the risk for new psychopathology is largely confined to those with a lifetime history of psychopathology.