Psychopathology in Patients with ICDs over Time: Results of a Prospective Study

Kapa, Suraj; Rotondi-Trevisan, Debra; Mariano, Z.; Aves, Theresa; Irvine, Jane; Dorian, Paul; Hayes, David L.

doi:10.1111/j.1540-8159.2009.02599.x

Cited by 101 publications

(95 citation statements)

References 37 publications

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“…10 These rates dropped significantly in the first 6 months after implantation to 12% and remained stable at 13% at 1 year. Despite an initial reduction in the number of patients with PTSD, a recent study found that 2 years after implant, there is a substantially greater prevalence of PTSD in ICD patients.…”

Section: Prevalence and Clinical Impact Of Ptsdmentioning

confidence: 99%

“…24 Moreover, ICD patients with elevated PTSD scores after device implantation were significantly more likely to have shock storm. 10 Furthermore, elevated PTSD scores were associated with a 3.2 times greater likelihood of mortality within 5 years compared with ICD patients with no to moderate symptom levels of PTSD, even after controlling for disease and demographic parameters. 14 In addition to understanding the prevalence of psychosocial distress, possessing a working knowledge of the presentation of psychosocial distress in ICD patients is the most helpful method of facilitating appropriate intervention.…”

Section: Prevalence and Clinical Impact Of Ptsdmentioning

confidence: 99%

“…4 Longitudinal assessment of anxiety has indicated that approximately 35% of patients at periimplant met cutoff criteria for anxiety, whereas approximately 15% of patients remained above cutoff for anxiety at 6-and 12-month follow-up. 10 Self-reported anxiety is also predictive of self-reported general health in ICD patients. 11 Significant depressive symptoms for ICD patients range from 10% to 41%.…”

Section: Prevalence and Impact Of Psychosocial Distressmentioning

confidence: 99%

“…Ladwig et al 14 found that prior ICD shocks had no influence on experience of PTSD symptoms. In addition, Kapa et al 10 found that the only difference between ICD patients with shocks and those with no shocks was in the SF36 physical component score. Therefore, despite the fact that the occurrence of ICD shock, the experience of cardiac arrest, or being told of the potential threat seem qualitatively different, there is no current evidence that they result in disparate incidence of PTSD in the first year after implantation.…”

Section: Conceptualization and Illustrative Case Presentationmentioning

confidence: 99%

See 3 more Smart Citations

Posttraumatic Stress and the Implantable Cardioverter-Defibrillator Patient

Sears

Hauf

Kirian

et al. 2011

Circ: Arrhythmia and Electrophysiology

115

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he implantable cardioverter-defibrillator (ICD) has revolutionized the care of patients at risk for life-threatening arrhythmias. Large-scale clinical trials established mortality benefits for the ICD over usual care or medications 1,2 and led to wider use for both primary and secondary prevention indications. More recent research confirms that the mortality benefits of the ICD extend over 8-year follow-up when compared with usual care. 3 These clinical trial successes, in terms of mortality, have allowed for greater focus on patientcentered outcomes, such as quality of life, device acceptance, psychological well-being, and trauma reactions in research and clinical care. 4 Shock has been a primary focus in this work because of its potentially traumatic impact on the patient experience. Although there is mixed evidence on the effect of single ICD shocks, 5,6 the literature consistently supports the negative impact of Ͼ5 shocks on quality of life and emotional distress. 7,8 ICD shock has been a focus of research interest because it is a unique experience for the ICD patient and can be perceived as a traumatic event. In addition, the existence of concomitant heart disease, angina, congestive heart failure, or previous sudden death may create sensitivity to traumatic stress that warrants improved understanding by attending electrophysiologists. Although psychological distress in ICD patients has been explored, the possibility that some ICD patients have trauma reactions, up to and including posttraumatic stress disorder (PTSD), has garnered increased attention recently. Therefore, the purposes of this report are to highlight the theory and research addressing psychological distress including PTSD in electrophysiology clinics, to discuss clinical management of these sequelae, and to suggest areas of future research and development. Psychosocial Distress of ICD Patients in Electrophysiology ClinicsPrevention and identification of distress in ICD patients represents comprehensive, high-quality care, regardless of the cause (eg, depression, anxiety, trauma), consistent with the biopsychosocial model of care. 9 This model of care entails the conceptualization and treatment of health problems as an interplay between biological factors, psychological factors, and social factors culminating in the manifestation of symptoms. For an electrophysiologist, these ambitious goals can include prevention of distress through cardiac care and education, recognition of distress warranting referral, optimizing quality-of-life (QoL) outcomes, and promoting patient acceptance of the ICD. Clearly, these are not easily accomplished without sufficient awareness, clinical support, and interdisciplinary expertise. Below are some key considerations for daily clinical practice. Prevalence and Impact of Psychosocial DistressGeneral or ICD-specific anxiety as a psychological morbidity has a point prevalence of 13% to 38% of ICD recipients in cross-sectional research. 4 Longitudinal assessment of anxiety has indicated that approximately 35% of pati...

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Section: Prevalence and Clinical Impact Of Ptsdmentioning

confidence: 99%

Section: Prevalence and Clinical Impact Of Ptsdmentioning

confidence: 99%

Section: Prevalence and Impact Of Psychosocial Distressmentioning

confidence: 99%

Section: Conceptualization and Illustrative Case Presentationmentioning

confidence: 99%

See 2 more Smart Citations

Posttraumatic Stress and the Implantable Cardioverter-Defibrillator Patient

Sears

Hauf

Kirian

et al. 2011

Circ: Arrhythmia and Electrophysiology

115

View full text Add to dashboard Cite

show abstract

“…Doraźne leczenie powinno spowodować określenie przyczyny wyła-dowań urządzenia, natomiast ważnym uzupełnieniem jest leczenie dystresu psychologicznego [229]. Poziom stresu może być różny, ale u pacjentów mogą też występować bardziej nasilone postaci choroby, takie jak zespół stresu pourazowego [232,233], który wiąże się z wcześniejszymi wyładowaniami oraz stresem przed wszczepieniem ICD [234]. U pacjentów z niedawną tachyarytmią może również występować lęk w oczekiwaniu na kolejne wyładowanie [235].…”

Section: Psychospołeczne Następstwa Leczenia Za Pomocą Implantowanychunclassified