P950Psychological adjustment in patients with an implantable cardioverter defibrillator (ICD): primary prevention vs secondary prevention

Introduction: Implantable cardioverter defibrillator (ICD) is a treatment on ventricular arrhythmias, both in primary and secondary prevention. The studies found a high percentage of psychopathological disorders in these patients and although acceptance of the device is usually high, those in primary prevention did not see the need for the device. Objectives: The aim of this study was to analyse whether there are differences in the psychological adjustment of patients with an ICD according to primary or secondary prevention. Methods: The instruments were administered to a total sample of 82 patients, 75.6% male (62) and 24.4% female (20). Average age was 54.6 years (from 19 to 78 years). The instruments used included a questionnaire with data for age, sex, marital status, years of implantation, fear of shock and discomfort caused by illness. Questionnaire (LSB-50) was also given which evaluates and identifies the presence of psychological and psychosomatic symptoms. Statistical tests were carried out on differences between the mean of independent samples (t student) and analysis through contingency tables. Significance level was p ≤ 0.05. Results: No significant differences were found between the mean of either primary or secondary prevention groups in the following scales: Psychoreactivity (0.59±0.59 vs 1.29±4.91), Hypersensitivity (0.33±0.49 vs 0.26± 0.55). Obsession-Compulsion (0.85±0.80 vs 0.69±0.52), Anxiety (0.33±0.42 vs 0.24±0.32) Somatisation (0.74±0.60 vs 0.48±0.45), Depression (0.69± 1.13 vs 0.40±0.40), Sleep disorders (1.34±1.16 vs 1.33±1.36 and in the psychological risk index (0.31±0.35 vs 0.18+-0.26). However, there were differences in Hostility (0.30±0.41 vs 0.37±0.51) this having the highest score in the secondary group. No statistically significant differences were found regarding fear of receiving discharges between the primary (22.92%) and secondary (29.41%) prevention groups (z=-0.664, p=0.506). As for discomfort due to illness, no statistically significant differences were found between primary or secondary prevention groups (z=1.133, p=0.2572). 25% of primary prevention patients showed a moderate or intense level of discomfort, compared to 14.71% of total secondary prevention patients. Conclusions: Both primary and secondary prevention groups wearing ICD showed a similar psychological adjustment; the only difference being in Hostility, with the secondary prevention group showing greater loss of emotional control, aggression, anger and resentment. Both groups showed no differences as regards fear of receiving discharges and discomfort due to illness.