SEVERE DEPRESSION IN WOMEN AFTER CARDIAC SURGERY

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Women account for 27% of the estimated 573,000 coronary artery bypass (CABG) graft surgeries performed annually and suffer greater perioperative mortality and post-operative morbidity, including depression, than men. Depression is a predictor of both mortality and morbidity in other cardiac patients. It has been associated with decreased cell-mediated immunity. While depression after CABG is common, little is known about its severity or its association with post-operative outcomes, such as immune function, infectious complications, functional status, psychosocial adjustment, and quality of life. A structured cognitive behavioral intervention designed specifically to relieve depression has not been tested during early postoperative recovery of CABG patients, even though it is the therapy of choice for mild to moderate depression. The proposed research plan has two overall objectives. The first objective is to obtain evidence regarding the risk of postoperative complications associated with compromised immune function in depressed women compared to non-depressed women undergoing CABG. The second objective is to describe the application of cognitive behavioral therapy in depressed women early after CABG. The overall objective of the proposed award is to increase the applicant's knowledge in immunology and in the delivery of cognitive behavioral therapy, so that she is better equipped to pursue a research career in biobehavioral science. A 3-year training plan is proposed. The plan incorporates formal classes in immunology and cognitive behavioral therapy with laboratory training, under the direction of scientists and clinical experts, in each field. The research proposed as part of the award is designed to completed the applicant's formal and laboratory training.