Spezzaferri Rosa, Modica Maddalena, Racca Vittorio, Ripamonti Vittorino, Tavanelli Monica, Brambilla Gabriella, Ferratini Maurizio
Unità Operativa di Cardiologia Riabilitativa, Centro IRCCS "Santa Maria Nascente", Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy.
Monaldi Arch Chest Dis. 2009 Dec;72(4):200-5. doi: 10.4081/monaldi.2009.318.
Coronary artery by-pass surgery (CABG) is often followed by anxiety and depression that require early identification in order to provide adequate psychological support. The predictive role of tests administered soon after CABG on long-term psychological outcomes has been only incompletely explored. AIM, DESIGN AND METHODS: Aim of this study was to assess post-operative and 12-month persistence of psychological disorders by means of the Minnesota Multiphasic Personality Inventory (MMPI-2) and the depression and state and trait anxiety scales of the Cognitive Behavioural Assessment (CBA-2.0) in 118 male patients admitted to cardiac rehabilitation after CABG.
Early after CABG we observed a high prevalence of depression (11.8% by MMPI-2 and 12.7% by CBA) and state anxiety (23.5%). At 1-year the MMPI-2 scale D indicated stable mean score and high scores at entry were predictive of persistent depression. Conversely the CBA-2.0 scale QD score significantly decreased (from 3.86 +/- 3.19 to 2.91 +/- 3.45, p = 0.017). Also ST1 state anxiety significantly decreased (from 35.17 +/- 6.95 to 32.55 +/- 6.72, p = 0.003) whereas ST2 trait anxiety was stable. We found no association between psychometric results and ventricular function, number of grafts or time since diagnosis of coronary artery disease.
State anxiety and depression by CBA significantly decreased 1-year after CABG; conversely trait anxiety and depression, investigated by MMPI-2, a more specific personality questionnaire, were stable. High scores for the depression in the scale D of MMPI-2 early after CABG seem to be predictive of the persistence of the disorder at 1-year.
冠状动脉搭桥手术（CABG）后常伴有焦虑和抑郁，需要早期识别以便提供充分的心理支持。CABG后不久进行的测试对长期心理结果的预测作用尚未得到充分研究。目的、设计与方法：本研究旨在通过明尼苏达多相人格调查表（MMPI-2）以及认知行为评估（CBA-2.0）的抑郁、状态和特质焦虑量表，评估118例接受CABG后进入心脏康复治疗的男性患者术后及12个月时心理障碍的持续情况。
CABG术后早期，我们观察到抑郁（MMPI-2评估为11.8%，CBA评估为12.7%）和状态焦虑（23.5%）的高患病率。1年后，MMPI-2量表D显示平均得分稳定，入院时高分可预测持续性抑郁。相反，CBA-2.0量表QD得分显著降低（从3.86±3.19降至2.91±3.45，p = 0.017）。ST1状态焦虑也显著降低（从35.17±6.95降至32.55±6.72，p = 0.003），而ST2特质焦虑保持稳定。我们发现心理测量结果与心室功能、移植血管数量或冠状动脉疾病诊断后的时间之间无关联。
CABG术后1年，CBA评估的状态焦虑和抑郁显著降低；相反，通过更具特异性的人格问卷MMPI-调查的特质焦虑和抑郁保持稳定。CABG术后早期MMPI-2量表D中抑郁高分似乎可预测1年后该障碍的持续性。
