Major or mild depression disturbs many patients following heart bypass surgery usually because of the dramatic changes in their lives. They have to depend on family members for help during their recovery and avoid activities they once enjoyed. Patients need to make drastic changes to their diet to prevent further heart disease and take special care in practicing healthy lifestyles, avoiding habits like smoking or getting more active. The adjustments in their lives can lead to depression until life seems normal again.
Function
Heart bypass, also called coronary artery bypass surgery, works by rerouting arteries around blocked arteries so the heart can pump blood more efficiently. The procedure alleviates severe chest pain and prevents further heart problems in many cases.
Significance
About one in five heart bypass patients experiences an episode of major depression after surgery and many develop mild depression, according to researchers at Washington University School of Medicine, St. Louis. Depression may complicate the recovery process and interfere with a patient's thinking and learning abilities. Physical and emotional recovery may take longer. Depression also worsens the quality of the patient's life and may increase the risk of more heart problems or even death.
Effects
Patients who experience depression following heart bypass surgery are twice as likely to die from heart problems within seven years of surgery compared to patients who are not depressed, according to the University of Maryland Medical Center. Researchers at the University of Maryland and Columbia University Medical Center conducted detailed psychiatric interviews with 309 heart bypass patients at one year and five to seven years following surgery. The study, reported at the American Psychosomatic Society in 2006, found that 20 percent of depressed patients died from heart difficulties compared to 12 percent who were not depressed.
Potential
Cognitive behavior therapy, which helps people change their thinking patterns for more positive results, and stress management programs help relieve depression for heart bypass patients, according to the Washington University researchers, who reported on their study in the April 2009 issue of "Archives of General Psychiatry." The research examined three recovery groups that included patients undergoing therapy, stress management or routine aftercare. More patients in the cognitive behavior therapy had remission from depression, at a rate of 73 percent, than the other groups after nine months. For the stress management group, 57 percent saw improvement from depression. Only 35 percent of the patients in routine care experienced relief from depression.
Benefits
Aftercare that includes more attention to the patient improves quality of life and physical functioning compared with usual care during recovery, ScienceDaily states. In a program called "Bypassing the Blues," researchers at the University of Pittsburgh School of Medicine looked at 302 depressed patients who underwent either detailed, collaborative care or usual care following surgery. The patients in detailed care received weekly telephone calls from a nurse, who collaborated with primary care physicians, psychiatrists, psychologists and internists. Patients in the collaborative care program had a 50 percent reduction in depressed mood symptoms compared to about 29 percent in the usual care group during an eight-month follow-up. The study, published in the Nov. 16, 2009 issue of the "Journal of the American Medical Association," shows that screening heart bypass patients for depression is an important factor in the recovery process, the researchers report.
References
- ScienceDaily: Two Non-Drug Treatments Appear To Reduce Depression After Heart Surgery
- University of Maryland Medical Center: DEPRESSION AFTER HEART BYPASS DOUBLES THE RISK OF DEATH FROM HEART PROBLEMS, ACCORDING TO NEW STUDY
- ScienceDaily: Bypassing the Blues: Telephone Treatment for Depression Post-Bypass Surgery Improves Quality of Life
- "Journal of the American Medical Association"; Telephone-Delivered Collaborative Care
