Attachment anxiety predicts depression and anxiety symptoms following coronary artery bypass graft surgery.

Tara Kidd,Amy Ronaldson,Andrew Steptoe,Marjan Jahangiri,Elizabeth Leigh,Lydia Poole

doi:10.1111/bjhp.12191

Abstract

ObjectiveDepression and anxiety are associated with poor recovery in coronary artery bypass graft (CABG) patients, but little is known about predictors of depression and anxiety symptoms.DesignWe tested the prospective association between attachment orientation, and symptoms of depression and anxiety in CABG patients, 6–8 weeks, and 12 months following surgery.MethodOne hundred and fifty‐five patients who were undergoing planned CABG surgery were recruited. Patients completed questionnaires measuring attachment, depression, and anxiety prior to surgery, then 6–8 weeks, and 12 months after surgery.ResultsAttachment anxiety predicted symptoms of depression and anxiety at both follow‐up time points, whereas attachment avoidance was not associated with depression or anxiety symptoms. The findings remained significant when controlling for baseline mood scores, social support, demographic, and clinical risk factors.ConclusionThese results suggest that attachment anxiety is associated with short‐term and long‐term depression and anxiety symptoms following CABG surgery. These results may offer important insight into understanding the recovery process in CABG surgery. Statement of contribution What is already known on this subject? Depression and anxiety symptoms are twice more likely to occur in coronary artery bypass graft (CABG) populations than in any other medical group.Depression and anxiety are associated with poor recovery following cardiac surgery.Predictors of depression and anxiety in CABG patients have been underexplored. What does this study add? This study highlights the importance of close interpersonal relationships on health.Attachment anxiety was prospectively associated with higher levels of depression and anxiety.These results add to understanding mechanisms linked to recovery following CABG.

Highlights

MethodsOne hundred and fifty-five patients who were undergoing planned coronary artery bypass graft (CABG) surgery were recruited
Attachment anxiety predicted symptoms of depression and anxiety at both follow-up time points, whereas attachment avoidance was not associated with depression or anxiety symptoms
These results suggest that attachment anxiety is associated with shortterm and long-term depression and anxiety symptoms following coronary artery bypass graft (CABG) surgery

Summary

Methods

One hundred and fifty-five patients who were undergoing planned CABG surgery were recruited. Patients completed questionnaires measuring attachment, depression, and anxiety prior to surgery, 6–8 weeks, and 12 months after surgery. Two hundred and sixty-five participants were recruited at a pre-surgery assessment clinic from a UK hospital, which was on average 29 days prior to surgery. Follow-up data were collected 6–8 weeks following surgery and at 12 months using postal questionnaires. Patients who had fully completed all the relevant baseline questionnaires and depression and anxiety questionnaires at 6–8 weeks and 12 months, who scored 19 or above on the Montreal Cognitive Assessment (MoCA; Nasreddine et al, 2005), had complete covariate data, and were undergoing elective CABG surgery (Ævalve replacement) were included in the analysis. Ethical approval was obtained from the National Research Ethics Service

Results

Discussion

Conclusion