Pedersen Susanne S, VAN DEN Berg Martha, Erdman Ruud A M, VAN Son Jenny, Jordaens Luc, Theuns Dominic A M J
Center of Research on Psychology in Somatic diseases, Tilburg University, Tilburg, The Netherlands.
Pacing Clin Electrophysiol. 2009 Feb;32(2):184-92. doi: 10.1111/j.1540-8159.2008.02201.x.
The partner of the implantable cardioverter-defibrillator (ICD) patient serves as an important source of support for the patient, which may be hampered if the partner experiences increased distress. We examined (1) potential differences in anxiety and depressive symptoms in ICD patients compared to their partners, and (2) the extent to which the partner's personality is a more important determinant of partner distress than patient clinical characteristics, using a prospective design.
Consecutively implanted ICD patients (n = 196) and their partners (n = 196) completed a set of psychological questionnaires at baseline and 6 months after implantation.
Analysis of variance with repeated measures showed that partners had significantly higher levels of anxiety compared to patients (F(1,390) = 16.431; P < 0.001) but not depressive symptoms (F(1,390) = 0.186; P = 0.67). There was a significant overall reduction in anxiety (F(1,390) = 79.552; P < 0.001) and depressive symptoms (F(1,390) = 39.868; P < 0.001) over 6 months, with group (i.e., patient vs partner) exerting a stable effect on anxiety (F(1,390) = 0.966; P = 0.33) and depressive symptoms (F(1,390) = 0.025; P = 0.87). These results remained in adjusted analysis. Determinants of anxiety and depressive symptoms in partners included secondary prophylaxis in patients (Ps < 0.001-0.002), Type D personality of the partner (Ps < 0.001-0.001), secondary prophylaxis by shock interaction (P = 0.002; anxiety only), and secondary prophylaxis by Type D interaction (Ps = 0.001-0.003).
Partners had higher levels of anxiety but not depression than ICD patients. Partner distress could be attributed not only to the partner's personality, but also to patient clinical characteristics, primarily secondary prophylaxis for ICD therapy. These results indicate that information on the clinical characteristics of the patient in addition to partner characteristics may help identify partners at risk of distress.
植入式心脏复律除颤器（ICD）患者的伴侣是患者重要的支持来源，如果伴侣的痛苦增加，这种支持可能会受到阻碍。我们采用前瞻性设计研究了：（1）ICD患者与其伴侣在焦虑和抑郁症状方面的潜在差异；（2）伴侣的性格比患者的临床特征在多大程度上更能决定伴侣的痛苦程度。
连续入选的196例植入ICD的患者及其196名伴侣在基线和植入后6个月完成了一系列心理问卷。
重复测量方差分析显示，伴侣的焦虑水平显著高于患者（F(1,390)=16.431；P<0.001），但抑郁症状无差异（F(1,390)=0.186；P=0.67）。在6个月期间，焦虑（F(1,390)=79.552；P<0.001）和抑郁症状（F(1,390)=39.868；P<0.001）总体上显著降低，组（即患者与伴侣）对焦虑（F(1,390)=0.966；P=0.33）和抑郁症状（F(1,390)=0.025；P=0.87）有稳定影响。这些结果在调整分析中依然成立。伴侣焦虑和抑郁症状的决定因素包括患者的二级预防（P<0.001 - 0.002）、伴侣的D型人格（P<0.001 - 0.001）、电击交互作用的二级预防（P = 0.002；仅焦虑）以及D型交互作用的二级预防（P = 0.001 - 0.003）。
伴侣的焦虑水平高于ICD患者，但抑郁水平无差异。伴侣的痛苦不仅可归因于伴侣的性格，还可归因于患者的临床特征，主要是ICD治疗的二级预防。这些结果表明，除了伴侣特征外，患者临床特征的信息可能有助于识别有痛苦风险的伴侣。
