Depression, anxiety disorders and Type D personality as risk factors for delirium after cardiac surgery

Phillip Tully, Robert Baker, Helen Winefield, Deborah Turnbull

    Research output: Contribution to journalArticle

    48 Citations (Scopus)

    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.

    Original languageEnglish
    Pages (from-to)1005-1011
    Number of pages7
    JournalAustralian and New Zealand Journal of Psychiatry
    Volume44
    Issue number11
    DOIs
    Publication statusPublished - Nov 2010

    Keywords

    • Coronary artery bypass grafts
    • Delirium
    • Major depression
    • Panic disorder
    • Type D personality

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