Depressive symptoms in patients with an implantable cardioverter defibrillator: Does treatment expectations play a role?

Susanne S Pedersen, Christina M Andersen, Johan Denollet, Mirela Habibovic

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Objective Patients with an implantable cardioverter defibrillator (ICD) and co-morbid depression are at greater risk of poor quality of life and premature death. We examined if treatment expectations predict depressive symptoms 12 months post implant. Methods First-time implant patients from the WEBCARE study (n = 177; 83.1% men) completed the EXPECTations towards ICD therapy questionnaire and the Type D Scale at baseline, and the Patient Health Questionnaire at baseline and 12 months. Results Using hierarchical linear regression with 3 models, we identified the following independent predictors of 12-months depressive symptoms: Model 1: Negative treatment expectations (β = 0.202; p = 0.020) and baseline depression (β = 0.376; p < 0.0001). Model 2: Baseline depression (β = 0.350; p < 0.0001) and Type D personality (β = 0.162; p = 0.042); negative treatment expectations was borderline significant (β = 0.169; p = 0.051). Model 3: Baseline depression (β = 0.353; p < 0.0001) and negative treatment expectations (β = 0.180; p = 0.043); Type D personality was not significant (β = 0.150; p = 0.067), adjusting for positive treatment expectations, heart failure, sex, and shocks during follow-up. The models accounted for 22.2%, 24.1%, and 23.3% of the variance in 12-months depressive symptoms, respectively. Conclusion Further research is warranted to explore the role of treatment expectations at the time of implant and its overlap with personality as a determinant of depression in patients with an ICD.

TidsskriftGeneral Hospital Psychiatry
Sider (fra-til)10-14
StatusUdgivet - 1. mar. 2018