Reduction in depressive symptoms in primary prevention ICD scheduled patients - One year prospective study

Gen Hosp Psychiatry. 2017 Sep:48:37-41. doi: 10.1016/j.genhosppsych.2017.06.013. Epub 2017 Jul 8.

Abstract

Objective: Implantable Cardioverter Defibrillators (ICDs), have previously been associated with the onset of depression and anxiety. The aim of this one-year prospective study was to evaluate the rate of new onset psychopathological symptoms after elective ICD implantation.

Methods: A total of 158 consecutive outpatients who were scheduled for an elective ICD implantation were diagnosed and screened based on the Mini International Neuropsychiatric Interview (MINI). Depression and anxiety were evaluated using the Hamilton Rating Scales for Depression (HAM-D) and Anxiety (HAM-A). Patient's attitude toward the ICD device was evaluated using a Visual Analog Scale (VAS).

Results: Patients' mean age was 64±12.4years; 134 (85%) were men, with the majority of patients performing the procedure for reasons of 'primary prevention'. According to the MINI diagnosis at baseline, three (2%) patients suffered from major depressive disorder and ten (6%) from dysthymia. Significant improvement in HAM-D mean scores was found between baseline, three months and one year after implantation (6.50±6.4; 4.10±5.3 and 2.7±4.6, respectively F(2100)=16.42; p<0.001). There was a significantly more positive attitude toward the device over time based on the VAS score [F(2122)=53.31, p<0.001].

Conclusions: ICD implantation significantly contributes to the reduction of depressive symptoms, while the overall mindset toward the ICD device was positive and improved during the one-year follow-up.

Keywords: Anxiety; Depression; Implantable cardioverter defibrillator/ICD; Primary prevention; Secondary prevention.

MeSH terms

  • Aged
  • Anxiety / diagnosis
  • Anxiety / epidemiology
  • Anxiety / prevention & control
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / psychology
  • Cardiovascular Diseases / therapy*
  • Comorbidity
  • Defibrillators, Implantable / psychology*
  • Defibrillators, Implantable / statistics & numerical data
  • Depression / diagnosis
  • Depression / epidemiology
  • Depression / prevention & control*
  • Depressive Disorder / diagnosis
  • Depressive Disorder / epidemiology
  • Depressive Disorder / prevention & control*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care* / statistics & numerical data
  • Primary Prevention* / statistics & numerical data
  • Secondary Prevention / statistics & numerical data