Prevalence and patterns of anxiety and depression in patients undergoing elective percutaneous transluminal coronary angioplasty.

BACKGROUND

The use of elective percutaneous transluminal coronary angioplasty (PTCA) as a treatment for coronary heart disease is increasing. Despite this, little is known about the prevalence and patterns of anxiety and depression experienced by patients undergoing and recovering from this procedure. Anxiety and depression are factors known to negatively influence recovery after a cardiac event.

OBJECTIVE

The purpose of this study was to (1) describe the levels of anxiety and depression reported by patients pre- and postelective PTCA, and (2) determine associations evident between anxiety and depression and the sociodemographic and clinical variables of gender, marital status, history of acute myocardial infarction, and attendance at cardiac rehabilitation.

METHODS

In this descriptive, repeated-measures investigation, patients (n = 140) were requested to complete the Spielberger State Trait Anxiety Inventory and Cardiac Depression Scale (CDS) at three time points: 0(1) before admission for elective PTCA (T(1)); (2) 6 to 8 weeks (T(2)) after PTCA; and (3) 6 to 8 months (T(3)) after PTCA.

RESULTS

A typical participant was male (75%), of European ethnicity (90%), aged 62 years (standard deviation = 10.7) with single or double vessel disease, and had attended cardiac rehabilitation in the past. At T(1), 16% of men and 24% of women had state anxiety scores comparable to those experienced by neuropsychiatric patients. Trait anxiety scores remained relatively constant over time; higher scores at T(1) were associated with past acute myocardial infarction. CDS scores at T(2) and T(3) were significantly lower than those at T(1). However, an unexpected increase in CDS scores occurred at T(3), compared with T(2). At T(3), 14% of men and 10% of women were depressed, relative to T(1).

CONCLUSION

The findings lend support for the closer surveillance of emotional status in this population. Specialist nurses have the potential to play a greater role in identifying those at risk of developing anxiety and depression. However, this unmet need will remain unmet until specialist nurses who spend the most face-to-face time with patients are equipped with the skills and resources to systematically identify those "at risk."