Abstract 1128: Depressive Symptoms After Cardiac Surgery: The Disappearing Act
In patients after cardiac surgery (CS) depressive symptoms have been reported to be common and severe. This study’s aim was to assess current prevalence and severity of depressive symptoms and determine the rate of clinical depression after CS.
Methods: We studied 559 CS patients (67±10 years, 30% female, 29% valve surgery/71% bypass, 80% on statins, 12% on antidepressants[ATD]). Inclusions were: Mini-Mental Status Exam > 24 and no other major psychiatric disorders by Structured Clinical Interview for DSM [SCID]. At hospital discharge (T1) and 4 – 6 weeks later (T2), patients completed the Beck Depression Inventory (BDI). If either T1 or T2 BDI was > 10 (showing clinical symptoms) and patients had H/O depression, a SCID was conducted by a trained researcher to determine clinical depression. The BDI-cognitive/affective subscale (BDI-CA) was calculated to remove somatic symptoms; a cutoff of > 3 was used to indicate clinical symptoms.
Results: At T1, mean BDI and BDI-CA scores were 7.2±5.0 and 2.7±1.06, respectively. At T2 (n=318), they were 7±5.0 and 2.3±1.0, respectively. The 75th percentiles for BDI-CA scores were 4 and 2.5, respectively (Figure⇓). Of 115 patients who agreed to a SCID, 51 (9.1% of all patients) had clinical depression. Compared to patients without CA symptoms, those with BDI-CA scores > 3 tended to have lower statin use (71.9% vs. 81.7%, p=.09) but higher ATD use (11.8% vs. 4.9%, p=.07).
Conclusions: The prevalence and severity of depressive symptoms and clinical depression after CS are lower now than reported previously. To explain the reduction in depression after CS, examination of changes in postop management, including the use of statins and ATDs, is warranted.