Feb. 4, 2003
BY BECKY HAM

Men who are depressed before their coronary artery bypass graft surgery are more likely to be re-hospitalized or suffer pain and reduced quality of life six months after their bypass operation, compared with men who are not depressed before the surgery, according to new research.

Rates of hospitalization for heart attack or artery disease rose among bypass patients with pre-operative depression, say Matthew M. Burg, Ph.D., of the VA Connecticut Healthcare System and colleagues.

Full physical and mental recovery also eluded many of these patients, who reported continued surgical pain and failure to return to their normal activities six months after the surgery.

The research may shed light on why 15 percent of bypass patients report little to no improvement in their health after the surgery, which provides benefits to most patients with coronary heart disease, according to the researchers.

Burg and colleagues gathered surgical, medical and psychological data on 89 male veterans before their bypass surgery and six months after surgery in a follow-up phone call. Of the 89 participants, 25 men were significantly clinically depressed before their bypass surgery.

"Of the 25 patients scoring positive for depression, six were hospitalized after the original surgery for cardiac reasons, compared with only two hospitalizations for cardiac reasons among the 64 patients scoring negative for depression," Burg says.

Patients who were depressed before surgery were also more likely to be depressed after surgery, although their depression symptoms were often unrecognized and untreated.

"The common thinking is that although depression is prevalent in patients during acute cardiac events, the depressive symptoms quickly dissipate after the event resolves. These data would argue to the contrary," says Burg.

Although the researchers did not identify the specific health problems behind the post-bypass hospitalizations, they suggest that these problems could be important in pinpointing whether depression is a contributing factor in ongoing coronary disease or an immediate factor in sabotaging the bypass itself.

The study is published in the January/February issue of Psychosomatic Medicine and supported by grants from the Veterans Administration and the National Heart, Lung and Blood Institute.

---Health Behavior News Service