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Increased anxiety in partners of patients with a cardioverter-defibrillator: the role of indication for ICD therapy, shocks, and personality

Author
Organization
Abstract
Background: The partner of the implantable cardioverter-defibrillator (ICD) patient serves as an important source of support for the patient, which may be hampered if the partner experiences increased distress. We examined (1) potential differences in anxiety and depressive symptoms in ICD patients compared to their partners, and (2) the extent to which the partner's personality is a more important determinant of partner distress than patient clinical characteristics, using a prospective design. Methods: Consecutively implanted ICD patients (n = 196) and their partners (n = 196) completed a set of psychological questionnaires at baseline and 6 months after implantation. Results: Analysis of variance with repeated measures showed that partners had significantly higher levels of anxiety compared to patients (F(1,390) = 16.431; P < 0.001) but not depressive symptoms (F(1,390) = 0.186; P = 0.67). There was a significant overall reduction in anxiety (F(1,390) = 79.552; P < 0.001) and depressive symptoms (F(1,390) = 39.868; P < 0.001) over 6 months, with group (i.e., patient vs partner) exerting a stable effect on anxiety (F(1,390) = 0.966; P = 0.33) and depressive symptoms (F(1,390) = 0.025; P = 0.87). These results remained in adjusted analysis. Determinants of anxiety and depressive symptoms in partners included secondary prophylaxis in patients (Ps < 0.001-0.002), Type D personality of the partner (Ps < 0.001-0.001), secondary prophylaxis by shock interaction (P = 0.002; anxiety only), and secondary prophylaxis by Type D interaction (Ps = 0.001-0.003). Conclusions: Partners had higher levels of anxiety but not depression than ICD patients. Partner distress could be attributed not only to the partner's personality, but also to patient clinical characteristics, primarily secondary prophylaxis for ICD therapy. These results indicate that information on the clinical characteristics of the patient in addition to partner characteristics may help identify partners at risk of distress.
Keywords
depressive symptoms, coronary artery disease, anxiety, implantable cardioverter-defibrillator, partner, Type D personality, QUALITY-OF-LIFE, SOCIAL INHIBITION, DEPRESSION SCALE, HOSPITAL ANXIETY, IMPLANTABLE DEFIBRILLATORS, PSYCHOLOGICAL REACTIONS, CARDIOVASCULAR-DISEASE, NEGATIVE AFFECTIVITY, FAMILY MEMBERS, STYLE CHANGES

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MLA
Pedersen, Susanne S et al. “Increased Anxiety in Partners of Patients with a Cardioverter-defibrillator: The Role of Indication for ICD Therapy, Shocks, and Personality.” PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY 32.2 (2009): 184–192. Print.
APA
Pedersen, Susanne S, Van Den Berg, M., Erdman, R. A., Van Son, J., Jordaens, L., & Theuns, D. A. (2009). Increased anxiety in partners of patients with a cardioverter-defibrillator: the role of indication for ICD therapy, shocks, and personality. PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, 32(2), 184–192.
Chicago author-date
Pedersen, Susanne S, Martha Van Den Berg, Ruud AM Erdman, Jenny Van Son, Luc Jordaens, and Dominic AMJ Theuns. 2009. “Increased Anxiety in Partners of Patients with a Cardioverter-defibrillator: The Role of Indication for ICD Therapy, Shocks, and Personality.” Pace-pacing and Clinical Electrophysiology 32 (2): 184–192.
Chicago author-date (all authors)
Pedersen, Susanne S, Martha Van Den Berg, Ruud AM Erdman, Jenny Van Son, Luc Jordaens, and Dominic AMJ Theuns. 2009. “Increased Anxiety in Partners of Patients with a Cardioverter-defibrillator: The Role of Indication for ICD Therapy, Shocks, and Personality.” Pace-pacing and Clinical Electrophysiology 32 (2): 184–192.
Vancouver
1.
Pedersen SS, Van Den Berg M, Erdman RA, Van Son J, Jordaens L, Theuns DA. Increased anxiety in partners of patients with a cardioverter-defibrillator: the role of indication for ICD therapy, shocks, and personality. PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY. 2009;32(2):184–92.
IEEE
[1]
S. S. Pedersen, M. Van Den Berg, R. A. Erdman, J. Van Son, L. Jordaens, and D. A. Theuns, “Increased anxiety in partners of patients with a cardioverter-defibrillator: the role of indication for ICD therapy, shocks, and personality,” PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, vol. 32, no. 2, pp. 184–192, 2009.
@article{8151416,
  abstract     = {Background: The partner of the implantable cardioverter-defibrillator (ICD) patient serves as an important source of support for the patient, which may be hampered if the partner experiences increased distress. We examined (1) potential differences in anxiety and depressive symptoms in ICD patients compared to their partners, and (2) the extent to which the partner's personality is a more important determinant of partner distress than patient clinical characteristics, using a prospective design. 
Methods: Consecutively implanted ICD patients (n = 196) and their partners (n = 196) completed a set of psychological questionnaires at baseline and 6 months after implantation. 
Results: Analysis of variance with repeated measures showed that partners had significantly higher levels of anxiety compared to patients (F(1,390) = 16.431; P < 0.001) but not depressive symptoms (F(1,390) = 0.186; P = 0.67). There was a significant overall reduction in anxiety (F(1,390) = 79.552; P < 0.001) and depressive symptoms (F(1,390) = 39.868; P < 0.001) over 6 months, with group (i.e., patient vs partner) exerting a stable effect on anxiety (F(1,390) = 0.966; P = 0.33) and depressive symptoms (F(1,390) = 0.025; P = 0.87). These results remained in adjusted analysis. Determinants of anxiety and depressive symptoms in partners included secondary prophylaxis in patients (Ps < 0.001-0.002), Type D personality of the partner (Ps < 0.001-0.001), secondary prophylaxis by shock interaction (P = 0.002; anxiety only), and secondary prophylaxis by Type D interaction (Ps = 0.001-0.003). 
Conclusions: Partners had higher levels of anxiety but not depression than ICD patients. Partner distress could be attributed not only to the partner's personality, but also to patient clinical characteristics, primarily secondary prophylaxis for ICD therapy. These results indicate that information on the clinical characteristics of the patient in addition to partner characteristics may help identify partners at risk of distress.},
  author       = {Pedersen, Susanne S and Van Den Berg, Martha and Erdman, Ruud AM and Van Son, Jenny and Jordaens, Luc and Theuns, Dominic AMJ},
  issn         = {0147-8389},
  journal      = {PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY},
  keywords     = {depressive symptoms,coronary artery disease,anxiety,implantable cardioverter-defibrillator,partner,Type D personality,QUALITY-OF-LIFE,SOCIAL INHIBITION,DEPRESSION SCALE,HOSPITAL ANXIETY,IMPLANTABLE DEFIBRILLATORS,PSYCHOLOGICAL REACTIONS,CARDIOVASCULAR-DISEASE,NEGATIVE AFFECTIVITY,FAMILY MEMBERS,STYLE CHANGES},
  language     = {eng},
  number       = {2},
  pages        = {184--192},
  title        = {Increased anxiety in partners of patients with a cardioverter-defibrillator: the role of indication for ICD therapy, shocks, and personality},
  url          = {http://dx.doi.org/10.1111/j.1540-8159.2008.02201.x},
  volume       = {32},
  year         = {2009},
}

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