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首页> 外文期刊>Psychosomatic Medicine: Journal of the American Psychosomatic Society >Optimism, response to treatment of depression, and rehospitalization after coronary artery bypass graft surgery
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Optimism, response to treatment of depression, and rehospitalization after coronary artery bypass graft surgery

机译：冠状动脉搭桥手术后的乐观情绪，对抑郁症的反应以及重新住院

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Objective: Optimism has been associated with a lower risk of rehospitalization after coronary artery bypass graft (CABG) surgery, but little is known about how optimism affects treatment of depression in post-CABG patients. Methods: Using data from a collaborative care intervention trial for post-CABG depression, we conducted exploratory post hoc analyses of 284 depressed post-CABG patients (2-week posthospitalization score in the 9-item Patient Health Questionnaire a‰1 10) and 146 controls without depression who completed the Life Orientation Test-Revised (full scale and subscale) to assess dispositional optimism. We classified patients as optimists and pessimists based on the sample-specific Life Orientation Test-Revised distributions in each cohort (full sample, depressed, nondepressed). For 8 months, we assessed health-related quality of life (using the 36-item Short-Form Health Survey) and mood symptoms (using the Hamilton Rating Scale for Depression [HRS-D]) and adjudicated all-cause rehospitalization. We defined treatment response as a 50% or higher decline in HRS-D score from baseline. Results: Compared with pessimists, optimists had lower baseline mean HRS-D scores (8 versus 15, p = .001). Among depressed patients, optimists were more likely to respond to treatment at 8 months (58% versus 27%, odds ratio = 3.02, 95% confidence interval = 1.28-7.13, p = .01), a finding that was not sustained in the intervention group. The optimism subscale, but not the pessimism subscale, predicted treatment response. By 8 months, optimists were less likely to be rehospitalized (odds ratio = 0.54, 95% confidence interval = 0.32-0.93, p = .03). Conclusions: Among depressed post-CABG patients, optimists responded to depression treatment at higher rates. Independent of depression, optimists were less likely to be rehospitalized by 8 months after CABG. Further research should explore the impact of optimism on these and other important long-term post-CABG outcomes.
机译：目的：乐观与冠状动脉搭桥术（CABG）术后再住院风险较低有关，但对乐观如何影响CABG后患者抑郁症的治疗知之甚少。方法：使用来自合作社干预干预试验中CABG抑郁症的数据，我们对284例CABG抑郁症患者进行了事后调查分析（9项患者健康问卷中的2周住院分值a‰1 10）和146没有抑郁症的对照者完成了“生活定向测验修订版”（全面量表和次量表），以评估性格乐观。我们根据每个队列（完整样本，抑郁，未抑郁）中针对特定样本的生命定向测试修订的分布，将患者分为乐观者和悲观者。在8个月的时间里，我们评估了与健康相关的生活质量（使用36项简短形式的健康调查）和情绪症状（使用了汉密尔顿抑郁量表[HRS-D]），并裁定了全因住院。我们将治疗反应定义为HRS-D得分较基线下降50％或更高。结果：与悲观主义者相比，乐观主义者的基线平均HRS-D得分较低（8比15，p = 0.001）。在抑郁症患者中，乐观者更有可能在8个月时对治疗做出反应（58％比27％，优势比= 3.02，95％置信区间= 1.28-7.13，p = 0.01），这一发现在抑郁症患者中并没有持续。干预组。乐观量表而非悲观量表预测治疗反应。到8个月时，乐观者重新入院的可能性较小（赔率= 0.54，95％置信区间= 0.32-0.93，p = .03）。结论：在CABG后抑郁症患者中，乐观者对抑郁症治疗的反应率更高。独立于抑郁症，在CABG术后8个月内，乐观主义者不太可能再次入院。进一步的研究应探讨乐观情绪对这些以及其他重要的CABG术后长期结果的影响。

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