The Relationship Between Psychological Symptoms and Ventricular Assist Device Implantation.

The Relationship Between Psychological Symptoms and Ventricular Assist Device Implantation.
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DOI:
10.1016/j.jpainsymman.2017.05.002
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发表时间:
2017-12
影响因子:
4.7
通讯作者:
Ascheim DD
Ascheim DD
中科院分区:
医学2区
文献类型:
--
作者:
Weerahandi H;Goldstein N;Gelfman LP;Jorde U;Kirkpatrick JN;Meyerson E;Marble J;Naka Y;Pinney S;Slaughter MS;Bagiella E;Ascheim DD

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心室辅助装置(VADs)可改善晚期心力衰竭(HF)患者的生活质量,但探究该人群心理症状的数据很少。 本研究检测了VAD患者随时间推移精神症状和疾病的患病率。 这项前瞻性多中心队列研究纳入了在VAD植入前后不久的患者,并对他们进行了长达48周的随访。使用PROMIS SF8a问卷评估抑郁和焦虑情况。采用《精神障碍诊断与统计手册》(DSM)的结构化临床访谈中的惊恐障碍、急性应激障碍(ASD)和创伤后应激障碍(PTSD)模块。 共纳入87名患者。植入后,抑郁和焦虑评分随时间显著下降(分别为p = 0.03和p < 0.001)。2名患者在植入后早期符合惊恐障碍标准,但症状随时间缓解。无人符合ASD或PTSD标准。 我们的研究表明,VADs不会造成严重的心理伤害,并且可能对抑郁和焦虑有积极影响。此外,在该队列中,VADs未诱发PTSD、惊恐障碍或ASD。
Ventricular assist devices (VADs) improve quality of life in advanced heart failure (HF) patients, but there are little data exploring psychological symptoms in this population. This study examined the prevalence of psychiatric symptoms and disease over time in VAD patients. This prospective multicenter cohort study enrolled patients immediately before or after VAD implant and followed them up to forty-eight weeks. Depression and anxiety were assessed with PROMIS SF8a questionnaires. The panic disorder, acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) modules of the Structured Clinical Interview for the DSM were used. Eighty-seven patients were enrolled. Post-implant, depression and anxiety scores decreased significantly over time (p=0.03 and p<0.001 respectively). Two patients met criteria for panic disorder early after implantation but symptoms resolved over time. None met criteria for ASD or PTSD. Our study suggests VADs do not cause serious psychological harms and may have a positive impact on depression and anxiety. Furthermore, VADs did not induce PTSD, panic disorder or ASD in this cohort.
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