Depression, anxiety, and cardiac morbidity outcomes after coronary artery bypass surgery: a contemporary and practical review

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Phillip J Tully(1Department of Surgery, Flinders Medical Centre and Flinders University of South Australia, 3 Flinders Drive, Bedford Park, SA 5042, Australia;School of Psychology,University of Adelaide Hughes Building, North Terrace, Adelaide, SA 5005, Australia;Discipline of Psychiatry, The University of Adelaide, Eleanor Harold Building, Frome Road, Adelaide, SA 5005, Australia;Heart Failure Self Management Pr)
Robert A Baker(Department of Surgery, Flinders Medical Centre and Flinders University of South Australia, 3 Flinders Drive, Bedford Park, SA 5042, Australia)
Journal Title:
Volume 09, Issue 02, 2012
Key Word:
Depression;Depressive disorder;Coronary artery bypass;Coronary artery disease;Antidepressive agents;Anxiety

Abstract: Research to date indicates that the number of coronary artery bypass graft (CABG) surgery patients affected by depression (i.e., major, minor, dysthymia) approximates between 30% and 40% of all cases. A longstanding empirical interest on psychosocial factors in CABG surgery patients highlights an association with increased risk of morbidity in the short and longer term. Recent evidence suggests that both depression and anxiety increase the risk for mortality and morbidity after CABG surgery independent of medical factors, although the behavioral and biological mechanisms are poorly understood. Though neither depression nor anxiety seem to markedly affect neuropsychological dysfunction, depression confers a risk for incident delirium. Following a comprehensive overview of recent literature, practical advice is described for clinicians taking into consideration possible screening aids to improve recognition of anxiety and depression among CABG surgery patients. An overview of contemporary interventions and randomized, controlled trials are described, along with suggestions for future CABG surgery research.

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