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Trajectories of Perceived Emotional and Physical Distress in Patients with an Implantable Cardioverter Defibrillator

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Abstract

Background

Little is known about the course of emotional and physical distress in patients with an implantable cardioverter defibrillator (ICD).

Purpose

We examined (1) trajectories of emotional and physical distress in the first 18 months postimplantation and (2) predictors of these trajectories, including demographical, clinical, and personality factors.

Methods

Dutch patients with an ICD (N = 645) completed measures on anxiety, depression, somatic symptoms, and perceived disability at the time of implantation, and 2, 12, and 18 months postimplantation. Measures on Type D personality (tendency to inhibit the expression of negative emotions) and anxiety sensitivity (tendency to fear anxiety-related sensations) were also completed at baseline.

Results

Latent class analysis (LatentGOLD) identified six to seven distinct trajectories, varying largely in overall levels of distress, and remaining relatively stable after a small initial decline. Multinomial regression showed that Type D personality and anxiety sensitivity were the most prominent predictors, particularly of trajectories that reflected higher distress levels. Cardiac resynchronization therapy and coronary artery disease also increased the risk for distress, whereas ICD indication and shocks did not.

Conclusions

The course of emotional and physical distress may be relatively stable after ICD implantation. In clinical practice, identification of patients with high risk of higher levels of emotional and physical distress may be warranted; as such, patients with high levels of anxiety sensitivity or a Type D personality should be identified and offered behavioral support.

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Acknowledgments

We would like to thank Ms. Eefje Postelmans and Mr. Hidde Weetink for inclusion of the patients into the study. This study was supported by the Netherlands Organization for Scientific Research, The Hague, The Netherlands with a VICI grant (453-04-004) to Prof. Dr. Johan Denollet.

Conflict of Interest

None.

Author information

Authors and Affiliations

  1. Department of Medical Psychology, CoRPS - Center of Research on Psychology in Somatic diseases, Tilburg University, PO Box 90153, 5000 LE, Tilburg, The Netherlands

    Krista C. van den Broek, Nina Kupper, Johan Denollet & Ivan Nyklíček

  2. Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands

    Pepijn H. van der Voort

  3. Department of Cardiology, Amphia Hospital, Breda, The Netherlands

    Marco Alings

Authors
  1. Krista C. van den Broek
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  2. Nina Kupper
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  3. Pepijn H. van der Voort
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  4. Marco Alings
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  5. Johan Denollet
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  6. Ivan Nyklíček
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Corresponding author

Correspondence to Krista C. van den Broek.

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van den Broek, K.C., Kupper, N., van der Voort, P.H. et al. Trajectories of Perceived Emotional and Physical Distress in Patients with an Implantable Cardioverter Defibrillator. Int.J. Behav. Med. 21, 149–159 (2014). https://doi.org/10.1007/s12529-012-9275-9

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  • DOI: https://doi.org/10.1007/s12529-012-9275-9

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