Psychological and Somatic Factors in Patients Undergoing Coronary Artery Bypass Graft Surgery: Towards Building a Psychological Framework

Abstract

The present study explored the relationships between psychological and somatic factors in patients undergoing Coronary Artery Bypass Graft surgery (CABG). The data-analysis of previous work was extended by adding somatic factors, including feelings of disability, somatic complaints and fatigue. The focus was on their relationships with psychological factors, including anxiety, depression and neuroticism. Prior to surgery and six months postoperatively, 217 patients completed self-report questionnaires. Using the method of structural equation modeling (SEM), the structure of relationships between the somatic, psychological and background factors (i.e., gender, age and medical factors) was explored. A model was developed providing a good fit and accounting for a substantial amount of variance. The structure of relationships revealed that somatic factors lead to anxiety and depression in the preoperative period, whereas anxiety and depression lead to somatic factors in the postoperative period. The structure further strengthened the key position of neuroticism and its overall negative prognostic implications.