PSYCHIATRIC MORBIDITY AND DEPRESSIVE SYMPTOMATOLOGY IN PATIENTS WITH PERMANENT PACEMAKERS

Implantation of a permanent pacemaker requires a psychological effort on the patient's part for adaptation in the acute term, and chronicall y, it restricts activities of the patient and may cause some psychiatr ic disturbances. To investigate psychiatric morbidity and depressive s ymptomatology of the patients with permanent pacemakers, 84 pacemaker patients were diagnosed using the DSM-III-R criteria and depressive sy mptoms were determined by modified Hamilton Depression Rating Scale (m HDRS). Sixteen (19.1%) patients had been given a psychiatric diagnosis . The most frequent diagnoses were adjustment disorder (5.9%) and majo r depressive episode (4.7%). Nine patients (10.7%) were diagnosed as h aving clinical depression (mHDRS greater than or equal to 17). The mea n score of mHDRS was 7.57 +/- 7.46, and the severity of depression was significantly higher in females. The most frequent symptoms are diffi culties in work and activities (53.6%), psychic anxiety (48.8%), loss of energy (42.9%), and hypochondriasis and insomnia (39.3%). Depressed mood, psychic anxiety, loss of energy, loss of interest, insomnia, an d hypochondriasis were significantly more frequent in females. Uneduca ted patients had a more significant loss of energy than educated patie nts. Depressed mood, psychic anxiety, and somatic concerns and symptom s were more frequent in patients with permanent pacemakers than in the general population. These symptoms, resembling mixed anxiety-depressi on disorder, were related to fears of having a permanent pacemaker, si nce our series were composed of uneducated patients who did not have e nough knowledge about the device.