개심술후 정신의학적 합병증

Psychiatric Complications following Open Heart Surgery

Pre-and post operative psychiatric evaluations were done using semi-structured interview with Hamilton scales for anxiety and depression in 57 open heart surgery receipients to assess post-operative psychiatric complications. Conspicuous post-operative psychiatric compli- cations were observed in 16 (28%) of 57 patients after open heart surgery. Postcardiotomy delirium occurred in seven patients; acute psychotic reaction with paranoid ideation in one; and neurotic reaction in eight. Factors that tended to influence postoperative psychiatric complications were older age, unempolyment, previous medical/psychiatric history, and high level of preoperative anxiety. By analysis of the preoperative psychiatric ：evaluation, patients could be largely divided in 3 groups; anxiety group, denial group, and adjusted group. Excessive anxiety and massive denial seemed to be signficant in the postoperative psychiatric compliactions. With these findings, the author’s impression was that the consultation psychiatrist should give comprehensive psychiatric evaluation and psychiatric preparation in pre-and post-opsn heart surgery for the possible prevention of postopertive psychiatric complications.