Key result
Among first-time ICD recipients, 30.5% to 52.5% of patients with elevated baseline psychological distress maintained increased levels over 24 months, compared to only 4% to 7.2% of patients with normal baseline scores who developed new distress.
Why the study?
The study was conducted to identify implantable cardioverter defibrillator patients at risk of distress, including depression, anxiety, and concerns, and to determine associated risk factors.
Observational (n=1,503)
Yes
First-time ICD patients with elevated baseline psychological distress are at high risk for persistent depression and anxiety over 24 months, highlighting the need for early screening and monitoring.
Persistent distress if elevated at baseline in first-time ICD recipients; hypothesis-generating for screening and intervention trials.
OBJECTIVE: Identify implantable cardioverter defibrillator (ICD) patients at risk of distress (i.e., depression, anxiety, and ICD concerns) and associated risk factors. METHOD: First-time ICD patients (n = 1503) from the Danish national DEFIB-WOMEN study completed questionnaires at baseline, 3, 6, 12 and 24 months. RESULTS: Of patients with low scores on distress, only 4%-7.2% experienced an increase in distress during 24 months of follow-up (FU), while 30.5%-52.5% with increased levels were likely to maintain increased levels at FU. Higher education, higher age, female sex, and good physical functioning at baseline were associated with less depression, anxiety and ICD concerns at FU. Previous psychological problems, smoking, Type D personality, NYHA class III-IV - all assessed at baseline - and shocks during FU were associated with depression, anxiety and ICD concerns. CONCLUSIONS: Generally, patients' psychological health improved, but patients with increased baseline scores were more likely to have increased scores at FU. We need to be vigilant if patients report elevated distress, particularly if they have depression at baseline, as depression seems more persistent. Given the impact of depression on health-related quality of life and prognosis, they should be screened and monitored closely.
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Pedersen et al. (2023) conducted an observational in First-time implantable cardioverter defibrillator (ICD) implantation (n=1,503). Elevated baseline psychological distress vs. Normal baseline psychological distress was evaluated on Elevated psychological distress (depression, anxiety, or ICD concerns) at 24 months. Among first-time ICD recipients, 30.5% to 52.5% of patients with elevated baseline psychological distress maintained increased levels over 24 months, compared to only 4% to 7.2% of patients with normal baseline scores who developed new distress.
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