PTSD and mood disorders in implantable cardioverter defibrillator patients: is more psychological assessment needed?

ABSTRACT

Introduction

The aim of this review is to identify common mood concerns in ICD patients and suggest brief psychological screeners essential for early detection and monitoring in patient care.

Areas covered

Reliable and valid psychological assessment tools are reviewed, including those specifically designed for ICD patient populations.

Expert opinion

Psychological assessment, in combination with cardiologic standard of care, can help overcome many barriers associated with poor implantable cardioverter-defibrillator (ICD) management and related cardiovascular outcomes. Earlier identification and treatment of mood concerns in ICD patients has been shown to improve quality of life (QOL) and patient outcomes. At this time, however, logistical challenges and time restraints, in addition to knowledge of appropriate treatment plans or referral options, remain central barriers to providing integrated, patient-centered care. Ultimately, all cardiology clinics would benefit from a collaborative care team that includes a mental health consultant or in-house psychologists who can provide consultations or referral services. Additionally, all patients that come to the clinics should complete proactive screening measures as routine component of care to assess the presence of mood concerns to improve patient outcomes and aid in treatment planning.

KEYWORDS:

• Implantable cardioverter-defibrillator
• psychological assessment
• patient management
• cardiac psychology
• mood
• post-traumatic stress disorder

Article highlights

• Mood concerns such as depression, anxiety, and post-traumatic stress are common in patients with implantable cardioverter-defibrillators (ICDs), with clinically significant rates ranging from 24–33% to 13–38%, respectively.

• Improved assessment strategies are needed in cardiology clinics for earlier detection of psychological distress and facilitate needed patient care.

• Standardized assessment measures exist for general psychological distress and cardiac-specific distress and are quick and easy to administer and interpret.

• Clinical and logistical challenges may exist that make implementation of psychological assessment daunting; however, practical solutions exist.

• Mental health is an integral aspect of the ICD patient experience, and authors recommend the use of a mental health consultant or in-house psychologist for comprehensive, integrated patient care.

Declaration of interest

Dr. Sears serves as a consultant to Medtronic and Abbott.Dr. Sears has received speaker honorarium from Medtronic and Zoll Medical in the last year.

Dr. Sears serves as a quality of life expert to Thryve, Tenaya, Fire 1, and Milestone Pharmaceuticals.

Additional information

Funding

This paper was not funded.