98. FIVE-FACTOR MODEL PERSONALITY TRAITS AS PREDICTOR OF POST CABG DEPRESSION: SUB-ANALYSIS OF NEUROPSYCHIATRIC OUTCOMES AFTER HEART SURGERY (NOAHS) STUDY

Abstract

Introduction

Coronary artery bypass graft surgery (CABG) is the most common cardiac surgery with an estimated 200,000 procedures annually in the United States. Depression after CABG surgery occurs in 30–40% of patients and is associated with higher morbidity and mortality. Identifying risk factors could lead to new prevention and treatment strategies for post-CABG depression. Psychological factors including personality traits have identified as a risk factor for coronary heart disease; however, few studies have examined the relationship between personality and post-CABG depression. We examined each of the five factors in the Five-Factor Model (FFM) of personality in association with post-CABG depression based on a subsample of the Neuropsychiatric Outcomes After Heart Surgery (NOAHS) study.

Methods

This is a secondary analysis of the Neuropsychiatric Outcomes After Heart Surgery (NOAHS) Study, which was a prospective, single-site study at a tertiary care academic center. Patients undergoing elective CABG surgery were recruited prior to surgery to complete the NEO Five-Factor Inventory (NEO-FFI) inventory, which is a 60-item assessment for personality traits. Before and one year after CABG, participants were evaluated for depression with the Diagnostic Interview Structured Hamilton (DISH). Depression was defined as either minor or major depression per DSM-IV. Subjects also completed patient Health Questionnaire (PHQ-9), Geriatric Depression Scale (GDS), 7-item Generalized Anxiety Disorder scale (GAD-7), and sociodemographic, medical, and neuropsychological assessment. We used independent samples t-tests to compare personality factors in those with vs without post-CABG depression. Next, we calculated unadjusted and adjusted odds ratios (ORs) with 95% CI, using logistic regression with the NEO-FFI factor t-scores as the main predictor variables and post-CABG depression as the outcome of interest while adjusting for potential confounding.

Results

We assessed 55 subjects (mean age: 65.1 ± 9.7 years; female: 26%; non-White: 85%). Four out of 55 subjects (7.3%) had pre-CABG depression, and 11 out of 54 subjects (20.4%; 1 missing) developed post-CABG depression. Subjects who developed post-CABG depression had higher t-scores on neuroticism (47.27 ± 12.95 vs 39.67 ± 6.59, p = .006) and lower t-scores on conscientiousness (47.29 ± 9.25 vs 54.80 ± 8.79, p = .015) than those without. Logistic regression models revealed a significant association between neuroticism t-score and post-CABG depression after adjusting for age, gender, and presence of pre-CABG depression (OR = 1.101, 95% CI [1.010, 1.101], p = .029). There was a statistically insignificant association between post-CABG depression and lower extraversion (OR = 0.932, 95% CI [0.858, 1.013], p =.097). Openness, agreeableness, and conscientiousness were not associated with post-CABG depression on logistic regression.

Conclusions

High neuroticism predicted post-CABG depression on unadjusted and adjusted models, with a suggestion that lower conscientiousness and lower extraversion may also be associated. This is consistent with previous findings that higher neuroticism and lower extraversion predict depressive episodes and suicidal thoughts in the general population. In line with the diathesis-stress model of depression, personality factors appear to represent a depression diathesis by way of interaction with the stress of CABG surgery.