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Ask the Mental Health Expert Archives 2001-2004

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Measuring Depression

Q. I read a news article about depression in patients having bypass surgery and would like to know what tool was used to measure the depression?

A. I assume you are talking about cardiac bypass surgery, but I'm not sure which article you have in mind. High levels of depression have been noted both before and after coronary artery bypass surgery (CABS). In one study by Underwood et al (Br Heart J 1993 May;69(5):382-4), anxiety, depression, and social adjustment were assessed in patients awaiting CABS.

Anxiety and depression were assessed by the Hospital Anxiety and Depression (HAD) scale. Twenty-eight per cent scored in the clinically significant range for anxiety, while 47% scored in the clinically significant range for depression. Time spent on the waiting list was positively and significantly related to depression. Silbert et al (J Cardiothorac Vasc Anesth 2001 Aug;15(4):439-44) compared the emotional state during the first 3 days after coronary artery surgery of patients who had undergone early versus conventional extubation (removal of the tube that goes down the airway).

Emotional status was measured by the Hospital Anxiety and Depression Scale (HAD), the Self Assessment Manikin (SAM), and the Multiple Affect Adjective Check List-Revised (MAACL-R). Tests were administered preoperatively and on the 1st and 3rd days postoperatively. Of patients in the conventional extubation group, 30% showed moderate-to-severe depressive symptoms (HAD score >10) on day 3 postoperatively, compared with 8% of patients in the early extubation group (p = 0.02).

There was a clinically insignificant increase in MAACL-R depression score on the 1st postoperative day within both groups but no other differences within or between groups in SAM or MAACL-R scores. The authors concluded that, "early extubation results in fewer patients displaying depressive symptoms on the 3rd postoperative day but appears to have little effect on other measurements of emotional status."

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March 2003

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