Depression with irritability in patients undergoing coronary artery bypass graft surgery: the cardiologist's role.
The purpose of this study was to investigate the determinants and maintenance factors of depression in patients undergoing coronary artery bypass graft (CABG) surgery. Fifty CABG candidates were selected randomly for evaluation before and after surgery. Depressive disorders occurred in 22.0% of the patients preoperatively and 21% postoperatively. Irritability as a symptom was more prevalent in depressed than nondepressed patients preoperatively (P=.04) and postoperatively (P=.006). Although depression was the most prevalent diagnosis in the patients' psychiatric histories and evaluations, benzodiazepines were prescribed more frequently than antidepressants (70% vs 3%). Cardiologists should consider that the irritability in some patients undergoing CABG may obscure the diagnosis of depression. The correct recognition of depression is essential to reduce inappropriate benzodiazepine prescription and to apply appropriate treatment.
Fráguas Júnior
R
R
Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
Ramadan
Z B
ZB
Pereira
A N
AN
Wajngarten
M
M
D000328:Adult; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001007:Anxiety / Q000175:diagnosis; D001569:Benzodiazepines; D002309:Cardiology; D001026:Coronary Artery Bypass / Q000523:psychology*; D003863:Depression / Q000175:diagnosis / Q000188:drug therapy*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007508:Irritable Mood; D008297:Male; D008875:Middle Aged; D010819:Physician's Role; D011182:Postoperative Care; D011300:Preoperative Care; D012189:Retrospective Studies; D016896:Treatment Outcome
D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D001569:Benzodiazepines