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|Title:||Depression, anxiety disorders and Type D personality as risk factors for delirium after cardiac surgery|
|Citation:||Australian and New Zealand Journal of Psychiatry, 2010; 44(11):1005-1011|
|Publisher:||Blackwell Publishing Asia|
|Phillip J. Tully , Robert A. Baker , Helen R. Winefield and Deborah A. Turnbull|
|Abstract:||Objectives: To determine the prognostic risk of incident delirium after cardiac surgery attributable to preoperative affective disorders and Type D personality. Methods: Patients awaiting elective coronary revascularization surgery (N _ 158; 20.9% female; 11.4% concomitant valve surgery; age M _ 64.7, SD _ 10.6) underwent the structured MINI International Neuropsychiatric Interview and completed a measure of Type D personality. Postoperative incident delirium was established prior to discharge from the index hospitalization with structured psychiatric interview. Results: The prevalence of psychiatric disorders before cardiac surgery was 17.1% for major depression, 7.6% for panic disorder, 10.1% for generalized anxiety disorder, and 13.3% for Type D personality, while there were 49 (31% of total) cases of delirium after surgery. After adjustment for sex, older age, cross-clamp time, haemoglobin (Hb) and psychotropic drug use, major depression was significantly associated with delirium, odds ratio (OR) _ 3.86 (95% confidence interval (CI) 1.42 to 10.52, p _ 0.001). Adjustment for clinical covariates suggested that Type D personality was not significantly associated with delirium, OR _ 2.85 (95%CI 0.97 to 8.38, p _ 0.06). Conclusions: Major depression was significantly associated with incident delirium after cardiac surgery. These findings suggest that the risk of incident delirium attributable to major depression was not merely a reflection of common diagnostic features in prospectively examined cardiac surgery patients.|
|Keywords:||coronary artery bypass grafts; delirium; major depression; panic disorder; Type D personality|
|Rights:||Copyright 2010 The Royal Australian and New Zealand College of Psychiatrists|
|Appears in Collections:||Psychology publications|
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