title: [Myocardial revascularization surgery, depressive symptoms and labeling effect].
abstract: BACKGROUND
  The individual awareness of one's own disease, the so called labeling effect, may result in a reduction of one's sense of perceived health. In patients submitted to coronary artery bypass surgery it has been reported that the diagnosis of depression is associated with a higher rate of hospitalization and it's an independent risk factor for cardiac events. The aim of this study was to evaluate the modification of depressive symptoms induced by the information of medical indication for myocardial revascularization surgery.
  
  
  METHODS
  We studied the presence of depressive symptoms, socio-demographic variables, cardiovascular status and therapeutic procedures in two groups of consecutive patients admitted for acute coronary syndrome. In the labeled group the BDI-1 was performed after clinical stabilization and the BDI-2 after the information of myocardial revascularization surgery need. In the control group the BDI-1 was answered after clinical stabilization and the BDI-2 48-72 hours later. The Mann-Whitney test was used to compare the difference of depressive symptoms between the groups.
  
  
  RESULTS
  Distribution by age, marital status and education level was similar between the two groups. The cardiovascular risk profile was alike. The difference between BDI-1 and BDI-2 was significantly higher in the labeled group (4.6-/+4.2 vs 0.8-/+3.2; p=0.005). There were no significant differences between the final diagnosis (unstable angina in the labeled group 50% vs control group 45.5%; AMI without Q wave 30% vs 27.3%; AMI with Q wave 20% vs 27.3%) and in hospital clinical evolution.
  
  
  CONCLUSIONS
  The individual awareness of the need to coronary bypass surgery was associated with a clinical and statistical significant increase of depressive symptoms. Hence, routine evaluation of depressive symptoms as a part of a preoperative protocol, may allow identification of the patients, who may benefit from therapeutic intervention.
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar de Vila Nova de Gaia.
authors.forename: Carla Costa
authors.initials: CC
authors.lastname: Dias
authors.forename: Pedro S
authors.initials: PS
authors.lastname: Mateus
authors.forename: Carlos
authors.initials: C
authors.lastname: Mateus
authors.forename: Nuno
authors.initials: N
authors.lastname: Bettencourt
authors.forename: Lino
authors.initials: L
authors.lastname: Santos
authors.forename: Luis
authors.initials: L
authors.lastname: Adão
authors.forename: Francisco
authors.initials: F
authors.lastname: Sampaio
authors.forename: Conceição
authors.initials: C
authors.lastname: Fonseca
authors.forename: Lino
authors.initials: L
authors.lastname: Simões
authors.forename: Rui
authors.initials: R
authors.lastname: Coelho
authors.forename: Vasco G
authors.initials: VG
authors.lastname: Ribeiro
mesh_terms: D000368:Aged; D001364:Awareness; D001026:Coronary Artery Bypass / Q000523:psychology; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D012959:Socioeconomic Factors; D018709:Statistics, Nonparametric