Boyer Bret A, Matour Susan J, Crittenden Kia B, Larson Kimberly A, Cox Jennifer Mayer, Link Darlene D
The Family Health Psychology Center, 506 West Mount Airy Avenue, Philadelphia, PA 19119, USA.
J Clin Psychol Med Settings. 2013 Jun;20(2):173-85. doi: 10.1007/s10880-012-9330-3.
Depression and posttraumatic stress (PTS) have been linked to medical/psychological outcomes following coronary artery bypass graft (CABG) surgery. This study assessed pre-surgical trauma history, PTS, and depression; and peri-surgical appraisals of fear, helplessness, and perceived life-threat among 110 patients. All CABGs were emergent, rather than elective, surgeries. In hierarchical multiple regressions, total severity score for pre-surgical PTS predicted fear regarding the cardiac event and the CABG, and perceived life-threat regarding the cardiac event and the CABG. Pre-surgical depression predicted perceived helplessness regarding the cardiac event and the CABG, and contributed to prediction of perceived life-threat. Trauma history contributed to prediction of fear and perceived helplessness regarding surgery (but not regarding the cardiac event necessitating surgery). When posttraumatic stress disorder diagnosis (PTSD) was entered, rather than total severity of PTS, PTSD did not predict any appraisals, and depression showed stronger prediction of fear, helplessness, and perceived life-threat than did PTSD.
抑郁症和创伤后应激障碍（PTS）与冠状动脉搭桥术（CABG）后的医学/心理结果有关。本研究评估了110名患者的术前创伤史、PTS和抑郁症；以及围手术期对恐惧、无助和感知到的生命威胁的评估。所有冠状动脉搭桥手术均为急诊手术，而非择期手术。在分层多元回归分析中，术前PTS的总严重程度评分可预测对心脏事件和冠状动脉搭桥术的恐惧，以及对心脏事件和冠状动脉搭桥术的感知生命威胁。术前抑郁症可预测对心脏事件和冠状动脉搭桥术的感知无助，并有助于预测感知生命威胁。创伤史有助于预测对手术的恐惧和感知无助（但与导致手术的心脏事件无关）。当纳入创伤后应激障碍诊断（PTSD）而非PTS的总严重程度时，PTSD无法预测任何评估结果，且抑郁症对恐惧、无助和感知生命威胁的预测能力比PTSD更强。
