Symptoms of Depression, Anxiety, and Posttraumatic Stress among Patients with Cardiac Pacemakers

Abstract

Despite being a prerequisite for tailoring specific therapeutic interventions, knowledge of pattern and prevalence of clinically significant psychiatric symptomatology among patients with cardiac pacemakers (PMs), especially of symptoms of posttraumatic stress, is limited. We studied symptoms of depression, anxiety, and posttraumatic stress among PM patients (PM due to syncope or presyncope) compared to participants of (i) a cardiac, (ii) a chronic disease, and (iii) a healthy control group. Symptoms of depression, anxiety and posttraumatic stress were measured by validated self-report scales at least 6 months after implantation of the PM (PM group; n = 38), percutaneous coronary intervention (PCI; PCI control group; n = 23), and first dialysis (Dialysis control group; n = 17). Blood donors constituted the Healthy control group (n = 42). Both PM, PCI, and dialysis patients reported depressive symptoms above clinical cut-off more frequently than the healthy controls (16.2, 26.1, 41.2, and 0%, respectively; p < 0.001). Self-report of symptoms of anxiety and posttraumatic stress did not differ significantly across study groups. However, a non-negligible proportion of PM patients reported on symptoms of posttraumatic stress of anticipated clinical relevance. Identification and treatment of depression deserves attention in clinical routine in all three patient populations. Further study of posttraumatic stress in PM patients seems advisable.