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Quality of Life Following Cardiac Surgery: Impact of the Severity and Course of Depressive Symptoms

From the Departments of Psychology (T.M.G., R.J.C.) and Sociology (E.L.I.), Rutgers, The State University of New Jersey, Piscataway, New Jersey; and the Department of Surgery, University of Medicine and Dentistry, New Jersey-Robert Wood Johnson Medical School, New Brunswick, New Jersey (T.J.K.).

Address correspondence and reprint requests to Richard J. Contrada, Department of Psychology, Rutgers University, 53 Avenue E, Piscataway, NJ 08854-8040. E-mail: contrada{at}rci.rutgers.edu.

Objectives: The purpose of this study was to examine the impact of the severity and course of depressive symptoms on change in quality of life (QOL) 6 months after cardiac surgery.

Methods: Ninety patients were interviewed before heart surgery and 2 and 6 months after surgery. Depressive symptoms were assessed using the Beck Depression Inventory, and QOL was assessed using physical and psychosocial functioning indices derived from the Medical Outcomes Study instrument. Multiple regression examined the effects of the severity and course of depressive symptoms on QOL adjusting for demographic and biomedical predictors.

Results: Higher levels of presurgical depressive symptoms predicted poorer physical functioning after cardiac surgery. A similar effect on psychosocial functioning fell short of significance. An increase in depressive symptoms 2 months after surgery was significantly predictive of poorer physical and psychosocial functioning at 6 months. The effect of increased depressive symptoms on psychosocial functioning was significantly stronger in patients with high presurgical Beck Depression Inventory scores.

Conclusions: Both preoperative depressive symptoms and postoperative increases in depressive symptoms seem associated with poorer QOL 6 months after cardiac surgery. Further examination of these associations and the mechanisms they reflect may provide a basis for guiding treatment decisions before and after coronary artery bypass graft surgery.

Key Words: coronary artery bypass graft surgery • depression • quality of life

Abbreviations: BDI = Beck Depression Inventory; CABG = coronary artery bypass graft surgery; MI = myocardial infarction; MOS = Medical Outcomes Study; QOL = quality of life; SF-36 = MOS 36-item short form health survey.

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