title: [Complexity of observable psychological distress after surgical myocardial revascularization in male subjects].
abstract: BACKGROUND
  Psychological disturbances like anxiety, depression, post-traumatic stress disorder are often associated with coronary artery disease and, in some studies, play a prognostic role after a coronary event. Despite some psychological disturbances following coronary artery bypass graft (CABG) have an impact on outcomes of both the surgical intervention and the rehabilitation program, their complexity as well as their clinical and instrumental determinants are still not fully understood. The aim of this study was to determine in male subjects with coronary artery disease the prevalence and complexity of psychological disturbances occurring after CABG as well as their predictors.
  
  
  METHODS
  One hundred eighteen males without history of psychological disturbances consecutively admitted to our rehabilitation inpatient service between September 2002 and September 2003 underwent 11 +/- 2 days after CABG extensive psychometric testing including the Minnesota Multiphasic Personality Inventory-2, the Cognitive Behavioral Assessment.2, and the Hamilton test. Cardiac evaluation included coronary risk factors, NYHA class, coronary heart disease history, medical therapy, CABG number, and echocardiography.
  
  
  RESULTS
  Mean age 63.7 +/- 8.1 years; ejection fraction 54.6 +/- 10.3%; NYHA class I 92.4%, NYHA class II and III 7.6%; CABG number 1 (11%), 2 (23.7%), 3 (39.8%), 4 (21.8%), 5 (4.2%); coronary artery disease length 64 +/- 85 months, hospital stay 31.3 +/- 8 days. The score was above clinical cut-off on scale for depression in 16-39.8% of the patients, state anxiety in 27.1%, trauma in 16.1%, type A personality in 16.1%. Subjects above clinical cut-off for depression, anxiety and trauma did not differ from subjects below in terms of clinical and instrumental characteristics. Age, ejection fraction, coronary risk factors, coronary heart disease duration, and CABG number did not predict the development of depression, anxiety and trauma. Psychological disturbances often clustered in the same subjects.
  
  
  CONCLUSIONS
  In males following CABG, psychological disturbances are extremely frequent, often clustered, and independent of subjects' characteristics and coronary heart disease severity.
authors: U.O. di Cardiologia Riabilitativa, Centro IRCCS S. Maria Nascente, Fondazione Don Carlo Gnocchi-ONLUS, Milano. cardiologia@dongnocchi.it
authors: Mariaconsuelo
authors: M
authors: Valentini
authors: Rosa
authors: R
authors: Spezzaferri
authors: Gabriella
authors: G
authors: Brambilla
authors: Monica
authors: M
authors: Tavanelli
authors: Maria
authors: M
authors: Sangiuliano
authors: Giorgio
authors: G
authors: Majorino
authors: Vittorio
authors: V
authors: Racca
authors: Maurizio
authors: M
authors: Ferratini
mesh_terms: D000368:Aged; D000465:Algorithms; D000704:Analysis of Variance; D001008:Anxiety Disorders / Q000209:etiology; D001026:Coronary Artery Bypass / Q000523:psychology*; D003324:Coronary Artery Disease / Q000523:psychology* / Q000601:surgery*; D003866:Depressive Disorder / Q000209:etiology; D006801:Humans; D008950:MMPI; D008297:Male; D001523:Mental Disorders / Q000209:etiology*; D008875:Middle Aged; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology