Premium
Do depression and anxiety profiles over time predict persistent post‐surgical pain? A study in cardiac surgery patients
Author(s) -
Pagé M. Gabrielle,
WattWatson J.,
Choinière M.
Publication year - 2017
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1002/ejp.998
Subject(s) - anxiety , depression (economics) , population , medicine , cardiac surgery , psychology , psychiatry , environmental health , economics , macroeconomics
Background Rates of depression and anxiety in cardiac surgery patients are higher than in the general population. The development of persistent post‐surgical pain ( PPSP ) in this population is also concerning. The objectives of this study were to (1) identify anxiety and depression trajectories of cardiac surgery patients over a 2‐year period; (2) examine demographic and clinical characteristics associated with trajectory memberships and (3) determine if anxiety and/or depression trajectories predict PPSP . Methods A total of 1071 patients completed questionnaires before cardiac surgery and 7 days, 3, 6, 12 and 24 months thereafter. Models were run using growth mixture modelling. Results Both anxiety and depression models yielded a 3‐trajectory solution. A minority of patients (< 10%) had unremitted major depression, almost one‐third of patients had remitted minor depression and the remaining patients had no depression over the 2‐year period. < 10% of patients had unremitted elevated anxiety, almost 40% of patients had unremitted mild anxiety symptoms, whereas half of patients did not experience anxiety over the same time period. Patients with unremitted elevated anxiety were more likely to report PPSP ; the association between depression and PPSP was not significant. Conclusions The results' novelty lies in the identification of a homogeneous patient subgroup presenting with unremitted elevated anxiety which predicted the presence of PPSP up to 2 years following cardiac surgery. Unlike anxiety, depression subgroups were not predictive of PPSP status. Significance This article presents the relationship between anxiety and depression profiles over 2 years in cardiac surgery patients and persistent post‐surgical pain. These results suggest the importance of evaluating how early identification and treatment of high‐risk patients could prevent PPSP . These results provide potential detection and prevention avenues of chronic pain for high‐risk patients based on their anxiety trajectory.