title: Frequency of depression and anxiety before and after insertion of a continuous flow left ventricular assist device.
abstract: Our objective was to investigate the course of depression and anxiety symptoms in patients treated with continuous flow (CF) left ventricular assist devices (LVADs). Depression and anxiety are associated with poor outcomes in patients with heart failure, yet few studies have examined such symptoms in patients with CF-LVADs. Depression and anxiety were measured as part of routine clinical care in patients who received a CF-LVAD at our institution from October 2009 to April 2012. Sixty-six patients completed the Patient Health Questionnaire-9, and 48 of 66 patients also completed the Generalized Anxiety Disorder Questionnaire-7. Nineteen of 66 patients completed measures before implantation. Patients who completed measures before and after implantation demonstrated significant improvements in depression and anxiety scores. All patients showed significant improvements in depression and anxiety scores from implantation to the first time point after implantation. Pairwise mean comparisons between time intervals after implantation were not significant. In conclusion, depression and anxiety scores improve after CF-LVAD implantation and remain stable up to 1 year. The improvement does not depend on baseline psychotropic medication use and may be related to improved physical health.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, NorthShore University HealthSystem, Evanston, Illinois.
authors.forename: Alison K
authors.initials: AK
authors.lastname: Reynard
authors.affiliation: Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Butler
authors.affiliation: Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Michael G
authors.initials: MG
authors.lastname: McKee
authors.affiliation: Kaufman Center for Heart Failure, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Randall C
authors.initials: RC
authors.lastname: Starling
authors.affiliation: Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio; Center for Connected Care, Cleveland Clinic, Cleveland, Ohio. Electronic address: eiraneiran@gmail.com.
authors.forename: Eiran Z
authors.initials: EZ
authors.lastname: Gorodeski
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000453:epidemiology* / Q000209:etiology; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000523:psychology / Q000628:therapy*; D006353:Heart-Assist Devices / Q000009:adverse effects* / Q000523:psychology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D055815:Young Adult