Beneficial effects of psychiatric intervention on recovery after coronary artery bypass graft surgery.
The effects of perioperative psychiatric intervention were studied in 33 patients undergoing coronary artery bypass graft (CABG) surgery. All patients were evaluated preoperatively using the Mini-Mental State Exam and the Psychological Adjustment to Illness Scale-Self-Report. Participants in the study group (N = 16) had a structured psychiatric interview prior to surgery and were followed daily with supportive psychotherapy throughout their hospitalization. The number of medical complications was higher in the control group. No significant differences were found in neurologic or psychologic complications. The study group used significantly more oxycodone-acetaminophen (Percocet), but less morphine-sulfate or benzodiazepine on postoperative days 3, 4, and 6. The mean length of stay was 3 days shorter for patients in the study group. In the current era of escalating health care costs and high technology, clinical protocols and research studies that evaluate the cost effectiveness and efficacy of psychiatric intervention in medically ill patients should be pursued.
Schindler
B A
BA
Department of Psychiatry, Medical College of Pennsylvania, Philadelphia 19129.
Shook
J
J
Schwartz
G M
GM
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001026:Coronary Artery Bypass / Q000523:psychology*; D003693:Delirium / Q000523:psychology; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D010149:Postoperative Pain / Q000523:psychology; D011183:Postoperative Complications / Q000523:psychology*; D011379:Prognosis; D011613:Psychotherapy; D012017:Referral and Consultation; D012307:Risk Factors; D012803:Sick Role