Psychological indices and phantom shocks in patients with ICD
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Some patients with ICDs experience the sensation of a shock in the absence of true therapy (phantom shock). We hypothesize that phantom shocks may be a manifestation of anxiety, depression or PTSD.
Methods and results
All patients over 18 years old with an ICD were eligible to enroll in the study. The first 75 subjects who agreed to participate were enrolled and divided into three groups: ICD patients with phantom shocks (n = 19); ICD patients who had actual shocks (n = 28) and ICD patients who had no shocks (n = 28). During a clinic visit a demographic questionnaire and three psychological rating scales were administered: the Spielberger State–Trait Anxiety Inventory (STAI); the Center for Epidemiologic Studies Depression Scale (CES-D) and the Posttraumatic Stress Checklist (PCL-C). No significant differences between groups were found in gender, race, age, history of MI or cardiac surgery status. Data analysis of the psychological indices using one-way ANOVA showed that the group with phantom shocks had more depression (CES-D p = 0.011) and more anxiety (STAI p = 0.010) than the other groups. Multiple comparisons of group means showed a greater percentage of clinically depressed patients in the phantom shock group than in the other groups.
Patients with phantom shocks are more likely to be clinically depressed and have higher levels of anxiety than other ICD patients, regardless of history of actual shocks.
KeywordsICD Shock Phantom shock Anxiety Depression PTSD
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- 1.Andrykowski, M. A., Cordova, M. J., Studts, J. L., & Miller, T. W. (1998). Posttraumatic stress disorder after treatment for breast cancer: Prevalence of diagnosis and use of the PTSD Checklist-Civilian Version (PCL-C) as a screening instrument. Journal of Consulting and Clinical Psychology, 66(3), 586–590.PubMedCrossRefGoogle Scholar
- 4.Buxton, A. E., Lee, K. L., Fisher, J. D., Josephson, M. E., Prystowsky, E. N., & Hafley, G., for The Multicenter Unsustained Tachycardia Trial Investigators. (1999). A randomized study of the prevention of sudden death in patients with coronary artery disease. New England Journal of Medicine, 341(25), 1882–1890.PubMedCrossRefGoogle Scholar
- 6.Conolly, S. J., et al. (2000). Canadian Implantable Defibrillator Study (CIDS). A randomized trial of the implantable cardioverter defibrillator against amiodarone. Circulation, 101, 1297–1302.Google Scholar
- 9.Duru, F., Buchi, S., Klaghofer, R., Mattmann, H., Sensky, T., Buddeberg, C., et al. (2001). How different from pacemaker patients are recipients of implantable cardioverter-defibrillators with respect to psychosocial adaptation, affective disorders and quality of life? Heart, 85(4), 375–379.PubMedCrossRefGoogle Scholar
- 18.Mason, S., & Rowlands, A. (1997). Post-traumatic stress disorder. Journal of Accident & Emergency Medicine, 14, 387–391.Google Scholar
- 20.Moss, A. J., et al., (Multicenter Automatic Defibrillator Implantation Trial Investigators). (1996). Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. New England Journal of Medicine, 335, 1933–1940.PubMedCrossRefGoogle Scholar
- 24.Parkes, J., Bryant, J., & Milne, R. (2000). Implantable cardioverter defibrillators: Arrhythmias. A rapid and systematic review. Health Technology Assess, 4, 1–5.Google Scholar
- 28.Radloff, L. S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychology Measurement, 1(3), 385–401.Google Scholar
- 32.Shron, E. B., Exner, D. V., Yao, Q., Jenkins, L. S., Steinberg, J. S., Cook, J. R., et al. (2002). Quality of life in the antiarrhythmics versus implantable defibrillators trial: Impact of therapy and influence of adverse symptoms and defibrillator shocks. Circulation, 105, 589–594.CrossRefGoogle Scholar
- 35.Speilberger, C. (1983). State Trait Inventory for Adults. Redwood City, California, Review Set. Mind Garden.Google Scholar
- 36.Swygman, C. A., Link, M. S., Cliff, D. L., Foote, C. B., Munther, K. H., Wang, P. J., et al. (1998, May 6–9). Incidence of phantom shocks in patients with implantable cardioverter defibrillators. San Diego, California: Abstract presented at North American Society of Pacing and Electrophysiology.Google Scholar
- 39.Weathers, F. W., Huska, J. A., & Keane, T. M. (1991). The PTSD Checklist—Civilian Version (PCL–C) (Available from F. W. Weathers, National Center for PTSD, Boston Veterans Affairs Medical Center, 150 S. Huntington Avenue, Boston, MA 02130).Google Scholar
- 40.Weathers, F. W., Litz, B. T., Herman, D. S., Huska, J. A., & Keane, T. M. (1993). The PTSD Checklist (PCL): Reliability, validity, and diagnostic utility. Paper presented at the meeting of the International Society for Traumatic Stress Studies, San Antonio, Texas.Google Scholar