• Coronary artery bypass surgery. Physical, psychological, social, and economic outcomes six months later

      Jenkins, C. David; Stanton, Babette-Ann; Savageau, Judith A.; Denlinger, Philip; Klein, Michael D. (1983-08-12)
      To evaluate the benefits of coronary artery bypass graft (CABG) surgery, we interviewed and tested 318 patients (268 men and 50 women) younger than age 70 before and six months after elective CABG at four university medical centers. Biomedical, psychoneurological, physical function, role function, occupational, social, family, sexual, emotional, and attitudinal variables were assessed. Quantitative comparisons showed improvement on many factors. Angina was completely relieved for 69% to 85% of persons, depending on whether it had been induced by exertion or other events. Disability days were reduced more than 80%. Seventy-five percent of employed persons had returned to work. Anxiety, depression, fatigue, and sleep problems declined. Vigor and well-being scores rose significantly. When losses were expected (eg, psychoneurological function, marital adjustment), they generally were not found. For none of the more than 60 outcome variables was widespread serious worsening found. The findings suggest that the great majority of patients are able to resume normal economic and social functioning within six months after CABG.
    • Neuropsychological deficits in psychotic versus nonpsychotic major depression and no mental illness

      Schatzberg, Alan F.; Posener, Joel A.; DeBattista, Charles; Kalehzan, Michelle; Rothschild, Anthony J.; Shear, Paula K. (2000-06-30)
      OBJECTIVE: At least three studies have indicated that patients with psychotic major depression studied under non-drug-free conditions differ from patients with nonpsychotic major depression and healthy comparison subjects on several measures of neuropsychological performance. The current study explored specific impairments in cognitive function in subjects with psychotic major depression, subjects with nonpsychotic major depression, and healthy comparison subjects studied under drug-free conditions. METHOD: A battery of neuropsychological tests was administered to 11 patients with psychotic major depression, 32 patients with nonpsychotic major depression, and 23 normal comparison subjects under drug-free conditions. The three groups did not differ statistically in age, sex, or level of education. To ensure that participants had minimal levels of severity and endogenicity, all patients were required to have a score of at least 20 on the 21-item Hamilton Depression Rating Scale and a score of at least 7 on the Core Endogenomorphic Scale, which uses eight items from the Hamilton depression scale. RESULTS: Patients with psychotic major depression demonstrated significantly greater impairment than patients with nonpsychotic major depression and/or comparison subjects in attention and response inhibition (as measured by the Stroop color-word subscale score) as well as in verbal declarative memory (as measured by the Paragraph Recall Test). CONCLUSIONS: These data indicate that patients with psychotic major depression demonstrate impairment in functions thought to be mediated by the frontal cortex and mediotemporal lobes.