Characteristics associated with anxiety, depressive symptoms, and quality-of-life in a large cohort of implantable cardioverter defibrillator recipients

Ingela Thylén, Rebecca L. Dekker, Tiny Jaarsma, Anna Strömberg, Debra K. Moser

Research output: Contribution to journalArticlepeer-review

49 Scopus citations


Objective: Although most patients with implantable cardioverter defibrillators (ICDs) adjust well, some have considerable psychological distress. Factors associated with psychological adjustment in ICD-recipients are still not well understood. Our purpose was to describe quality-of-life (QoL) and prevalence of self-reported symptoms of anxiety and depression in a large national cohort of ICD-recipients, and to determine socio-demographic, clinical, and ICD-related factors associated with these variables. Methods: A cross-sectional, correlational design was used. All eligible adult ICD-recipients in the Swedish ICD- and Pacemaker Registry were invited to participate. Symptoms of anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS), and QoL with the EuroQol-5D. Results: A total of 3067 ICD-recipients (66. ±. 11. years, 80% male) were included. The mean HADS score was 3.84. ±. 3.70 for anxiety symptoms and 2.99. ±. 3.01 for symptoms of depression. The mean EQ-5D index score was 0.82. ±. 0.21. The probability of symptoms of anxiety and depression was associated with younger age, living alone, and a previous history of myocardial infarction or heart failure. Additionally, female ICD-recipients had a higher probability of symptoms of anxiety. A higher level of ICD-related concerns was most prominently related to symptoms of anxiety, depressive symptoms and poorer QoL, while number of shocks, ICD-indication and time since implantation were not independently related. Conclusions: In this large cohort of ICD-recipients, the association of ICD-related concerns with symptoms of anxiety, depressive symptoms, and poor QoL suggests that ICD specific factors should be addressed in order to improve outcomes.

Original languageEnglish
Pages (from-to)122-127
Number of pages6
JournalJournal of Psychosomatic Research
Issue number2
StatePublished - Aug 2014

Bibliographical note

Funding Information:
The contributions of Rebecca Dekker were supported by a National Institutes of Health, National Institute of Nursing Research , K23 NR013480 award. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Nursing Research or the National Institutes of Health.


  • Anxiety
  • Depression
  • Implantable cardioverter defibrillator
  • Patient outcomes
  • Psychological distress
  • Quality-of-life

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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