A structural modeling analysis of anxiety and depression in patients undergoing coronary artery bypass graft surgery: A model generating approach

The present study is a longitudinal study designed to explore structural re lationships between anxiety, depression, personality, and background factor s (e.g., gender, age, and complicated medical characteristics) in patients undergoing coronary artery bypass graft (CABG) surgery. At two time points before and two after CABG, 217 patients completed self-report questionnaire s. To explore structural relationships, the structural equation modeling (S EM) method was applied. Using the model-generating approach, a model was de veloped, providing a good fit. The structural relationships revealed, in pa rticular, the key position of neuroticism, which was related to both pre- a nd postoperative anxiety and depression. Relationships between anxiety and depression over time, both intra- and interrelationships, were relatively w eak. Relationships between anxiety and depression at the same points in tim e were relatively strong, with preoperative depression leading to preoperat ive anxiety, and postoperative anxiety leading to postoperative depression. To provide a useful framework for development of intervention strategies, further research is needed to evaluate the plausibility of the final struct ural model. (C) 1999 Elsevier Science Inc.