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Resource Loss Predicts Depression and Anxiety Among Patients Treated With an Implantable Cardioverter Defibrillator

From the Department of Psychology, Kent State University, Kent, Ohio (F.S.L., J.W.H., D.W., R.J.); and Summa Health System, Akron, Ohio (J.W.H., D.W., R.J.).

Address correspondence and reprint requests to Joel W. Hughes, PhD, Department of Psychology, P.O. Box 5190, Kent, OH 44242. E-mail: jhughes1{at}kent.edu

Objective: Many patients treated with an implantable cardioverter defibrillator (ICD) experience clinically significant depression and anxiety after ICD implantation. As ICD use continues to evolve, it is important to understand the correlates of depression and anxiety to identify patients at greatest risk of poor psychological functioning. Conservation of resources theory, a general theory of stress, states that people experience greater stress if they perceive that they are losing personal, social, and material resources. We hypothesized that perceptions of resource loss would be related to symptoms of depression and anxiety after controlling for other known predictors.

Methods: One hundred patients treated with an ICD completed standardized depression and anxiety questionnaires along with questionnaires assessing social support, physical functioning, and resource loss. Clinical variables for patients were obtained from prospectively obtained medical records.

Results: Over 20% of the sample exhibited elevated symptoms of depression and anxiety. Patients' depression levels were associated with poor social support, poor physical functioning, a history of depression, and a greater length of time since ICD implantation. Having experienced one or more clinical ICD shocks was related to depression but not anxiety. Higher levels of perceived resource loss were associated with higher levels of both depression and anxiety after controlling for all other predictors.

Conclusions: Resource loss may help to determine psychological distress after ICD implantation. Understanding how resource loss contributes to depression and anxiety may help to identify patients at greatest risk of poor psychological functioning and may suggest treatment strategies.

Key Words: implantable cardioverter defibrillator • resource loss • depression • anxiety

Abbreviations: ICD = implantable cardioverter defibrillator; COR = conservation of resources; BDI = Beck Depression Inventory; STAI = State-Trait Anxiety Inventory.