title: Quality of life following cardiac surgery: impact of the severity and course of depressive symptoms.
abstract: OBJECTIVE
  The purpose of this study was to examine the impact of the severity and course of depressive symptoms on change in quality of life (QOL) 6 months after cardiac surgery.
  
  
  METHODS
  Ninety patients were interviewed before heart surgery and 2 and 6 months after surgery. Depressive symptoms were assessed using the Beck Depression Inventory, and QOL was assessed using physical and psychosocial functioning indices derived from the Medical Outcomes Study instrument. Multiple regression examined the effects of the severity and course of depressive symptoms on QOL adjusting for demographic and biomedical predictors.
  
  
  RESULTS
  Higher levels of presurgical depressive symptoms predicted poorer physical functioning after cardiac surgery. A similar effect on psychosocial functioning fell short of significance. An increase in depressive symptoms 2 months after surgery was significantly predictive of poorer physical and psychosocial functioning at 6 months. The effect of increased depressive symptoms on psychosocial functioning was significantly stronger in patients with high presurgical Beck Depression Inventory scores.
  
  
  CONCLUSIONS
  Both preoperative depressive symptoms and postoperative increases in depressive symptoms seem associated with poorer QOL 6 months after cardiac surgery. Further examination of these associations and the mechanisms they reflect may provide a basis for guiding treatment decisions before and after coronary artery bypass graft surgery.
authors.affiliation: Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, New Jersey, USA.
authors.forename: Tanya M
authors.initials: TM
authors.lastname: Goyal
authors.forename: Ellen L
authors.initials: EL
authors.lastname: Idler
authors.forename: Tyrone J
authors.initials: TJ
authors.lastname: Krause
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Contrada
mesh_terms: D000223:Adaptation, Psychological; D001026:Coronary Artery Bypass / Q000523:psychology*; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D006304:Health Status; D006350:Heart Valve Prosthesis / Q000523:psychology; D006801:Humans; D010555:Personality Inventory / Q000706:statistics & numerical data; D011300:Preoperative Care; D011379:Prognosis; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D012917:Social Adjustment; D011795:Surveys and Questionnaires