title: Psychological wellbeing and posttraumatic stress associated with implantable cardioverter defibrillator therapy in young adults with genetic heart disease.
abstract: BACKGROUND
  Sudden cardiac death is a tragic complication of a number of genetic heart diseases. Implantable cardioverter defibrillator (ICD) therapy plays an important role in prevention of sudden death. The psychological consequences of ICD therapy in young people with genetic heart disease are poorly understood. This study sought to better understand psychological wellbeing and identify symptoms of posttraumatic stress in young people who had experienced an ICD shock.
  
  
  METHODS
  Eligible patients (ICD implanted over 12 months prior) with an inherited cardiomyopathy or primary arrhythmogenic disorder, enrolled in the Australian Genetic Heart Disease Registry were included. Ninety patients completed the Hospital Anxiety and Depression Scale (HADS). Those patients who had an ICD shock (n=31) also completed the Impact of Events Scale-Revised (IES-R).
  
  
  RESULTS
  While the mean HADS-Anxiety and IES-R scores were within the normal range in the total group (n=90), a significant subgroup reported symptoms of anxiety (38%), depression (17%) and posttraumatic stress (31%) indicative of the potential need for referral to clinical care. Overall, greater psychological distress in ICD patients was associated with female gender, a history of syncope, other comorbid medical conditions, and reporting of other distressing events (i.e., ICD complications). In those with an ICD shock, higher posttraumatic stress scores were associated with female gender and longer time to first shock.
  
  
  CONCLUSIONS
  Patients with genetic heart diseases can experience psychological difficulties, including anxiety, depression and posttraumatic stress, related to ICD implantation and subsequent shocks. This signals the importance of offering patients access to targeted interventions, including psychological care and support.
authors.affiliation: Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, Sydney, Australia; School of Medicine, University of Sydney, Sydney, Australia.
authors.forename: Jodie
authors.initials: J
authors.lastname: Ingles
authors.forename: Tanya
authors.initials: T
authors.lastname: Sarina
authors.forename: Nadine
authors.initials: N
authors.lastname: Kasparian
authors.forename: Christopher
authors.initials: C
authors.lastname: Semsarian
mesh_terms: D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D001315:Australia / Q000453:epidemiology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D017147:Defibrillators, Implantable / Q000523:psychology*; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology / Q000235:genetics* / Q000523:psychology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012042:Registries; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D055815:Young Adult
keywords: Anxiety; Genetics; Implantable cardioverter defibrillator; Posttraumatic stress