Psychological Distress and Suicidal Ideation in Patients With Atrial Fibrillation: Prevalence and Response to Management Strategy
Background An association between atrial fibrillation (AF), anxiety, and depression is recognized, but the spectrum of psychological distress remains unclear. We aimed to characterize the severity and predictors of distress associated with AF in a tertiary population and its response to AF managemen...
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| Language: | English |
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Wiley
2018-09-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.117.005502 |
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| author | Tomos E. Walters Kate Wick Gabriel Tan Megan Mearns Stephen A. Joseph Joseph B. Morton Prashanthan Sanders Christina Bryant Peter M. Kistler Jonathan M. Kalman |
| author_facet | Tomos E. Walters Kate Wick Gabriel Tan Megan Mearns Stephen A. Joseph Joseph B. Morton Prashanthan Sanders Christina Bryant Peter M. Kistler Jonathan M. Kalman |
| author_sort | Tomos E. Walters |
| collection | DOAJ |
| description | Background An association between atrial fibrillation (AF), anxiety, and depression is recognized, but the spectrum of psychological distress remains unclear. We aimed to characterize the severity and predictors of distress associated with AF in a tertiary population and its response to AF management. Methods and Results Seventy‐eight patients with symptomatic AF underwent evaluation, including of AF symptom severity, health‐related quality of life, psychological distress, suicidal ideation, and specific personality traits. Twenty participants underwent AF ablation and 58 were managed medically, with repeat assessments at 4, 8, and 12 months. Severe distress (Hospital Anxiety and Depression Scale score, ≥15/42) was identified in 27 of 78 (35%). Independent predictors were a personality marked by vulnerability to stress (Perceived Stress Scale: R2, 0.54; β=0.7±0.1; t=7.8; P<0.001) and 1 marked by negativity/social inhibition (Type D Personality Scale: R2, 0.47; β=0.7±0.1; t=6.7; P<0.001). Suicidal ideation was reported by 16 of 78 (20%) and was predicted by personality traits (Perceived Stress Scale score: R2, 0.35; odds ratio, 1.22±0.06; P<0.001; Type D Personality Scale score: R2, 0.48; odds ratio, 1.43±0.14; P<0.001). Effective AF ablation (median AF burden 1% [0–1%] over 12 months) was associated with significant reductions in distress (Hospital Anxiety and Depression Scale score, 13.9±1.8 to 4.3±1.8; P<0.05) and prevalence of suicidal ideation (30–5%; P=0.02). Conclusions There was a high prevalence of severe psychological distress (35%) and of suicidal ideation (20%) in a tertiary AF population, with personality traits predicting both. Effective AF ablation was associated with significant improvements, suggesting AF itself may be a treatable causative factor of distress. |
| format | Article |
| id | doaj-art-3c29ca92cb5b4f408fe2a957581ef494 |
| institution | OA Journals |
| issn | 2047-9980 |
| language | English |
| publishDate | 2018-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-3c29ca92cb5b4f408fe2a957581ef4942025-08-20T02:34:40ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802018-09-0171810.1161/JAHA.117.005502Psychological Distress and Suicidal Ideation in Patients With Atrial Fibrillation: Prevalence and Response to Management StrategyTomos E. Walters0Kate Wick1Gabriel Tan2Megan Mearns3Stephen A. Joseph4Joseph B. Morton5Prashanthan Sanders6Christina Bryant7Peter M. Kistler8Jonathan M. Kalman9The Department of Cardiology Royal Melbourne Hospital Melbourne AustraliaThe Centre for Women's Mental Health Royal Women's Hospital Melbourne AustraliaThe Department of Cardiology Royal Melbourne Hospital Melbourne AustraliaThe Department of Cardiology Royal Melbourne Hospital Melbourne AustraliaThe Department of Cardiology Royal Melbourne Hospital Melbourne AustraliaThe Department of Cardiology Royal Melbourne Hospital Melbourne AustraliaThe Centre for Heart Rhythm Disorders South Australian Health and Medical Research Institute University of Adelaide AustraliaThe School of Psychological Sciences University of Melbourne AustraliaThe Department of Medicine University of Melbourne AustraliaThe Department of Cardiology Royal Melbourne Hospital Melbourne AustraliaBackground An association between atrial fibrillation (AF), anxiety, and depression is recognized, but the spectrum of psychological distress remains unclear. We aimed to characterize the severity and predictors of distress associated with AF in a tertiary population and its response to AF management. Methods and Results Seventy‐eight patients with symptomatic AF underwent evaluation, including of AF symptom severity, health‐related quality of life, psychological distress, suicidal ideation, and specific personality traits. Twenty participants underwent AF ablation and 58 were managed medically, with repeat assessments at 4, 8, and 12 months. Severe distress (Hospital Anxiety and Depression Scale score, ≥15/42) was identified in 27 of 78 (35%). Independent predictors were a personality marked by vulnerability to stress (Perceived Stress Scale: R2, 0.54; β=0.7±0.1; t=7.8; P<0.001) and 1 marked by negativity/social inhibition (Type D Personality Scale: R2, 0.47; β=0.7±0.1; t=6.7; P<0.001). Suicidal ideation was reported by 16 of 78 (20%) and was predicted by personality traits (Perceived Stress Scale score: R2, 0.35; odds ratio, 1.22±0.06; P<0.001; Type D Personality Scale score: R2, 0.48; odds ratio, 1.43±0.14; P<0.001). Effective AF ablation (median AF burden 1% [0–1%] over 12 months) was associated with significant reductions in distress (Hospital Anxiety and Depression Scale score, 13.9±1.8 to 4.3±1.8; P<0.05) and prevalence of suicidal ideation (30–5%; P=0.02). Conclusions There was a high prevalence of severe psychological distress (35%) and of suicidal ideation (20%) in a tertiary AF population, with personality traits predicting both. Effective AF ablation was associated with significant improvements, suggesting AF itself may be a treatable causative factor of distress.https://www.ahajournals.org/doi/10.1161/JAHA.117.005502atrial fibrillationpersonalitypsychological distressquality of lifesuicidal ideation |
| spellingShingle | Tomos E. Walters Kate Wick Gabriel Tan Megan Mearns Stephen A. Joseph Joseph B. Morton Prashanthan Sanders Christina Bryant Peter M. Kistler Jonathan M. Kalman Psychological Distress and Suicidal Ideation in Patients With Atrial Fibrillation: Prevalence and Response to Management Strategy Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease atrial fibrillation personality psychological distress quality of life suicidal ideation |
| title | Psychological Distress and Suicidal Ideation in Patients With Atrial Fibrillation: Prevalence and Response to Management Strategy |
| title_full | Psychological Distress and Suicidal Ideation in Patients With Atrial Fibrillation: Prevalence and Response to Management Strategy |
| title_fullStr | Psychological Distress and Suicidal Ideation in Patients With Atrial Fibrillation: Prevalence and Response to Management Strategy |
| title_full_unstemmed | Psychological Distress and Suicidal Ideation in Patients With Atrial Fibrillation: Prevalence and Response to Management Strategy |
| title_short | Psychological Distress and Suicidal Ideation in Patients With Atrial Fibrillation: Prevalence and Response to Management Strategy |
| title_sort | psychological distress and suicidal ideation in patients with atrial fibrillation prevalence and response to management strategy |
| topic | atrial fibrillation personality psychological distress quality of life suicidal ideation |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.117.005502 |
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