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August 1974

Personality and Psychological Factors in Postcardiotomy Delirium

Author Affiliations

From the Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York.

Arch Gen Psychiatry. 1974;31(2):249-253. doi:10.1001/archpsyc.1974.01760140093017

One hundred forty-two patients were observed through their openheart surgery experiences. Preoperative psychiatric ratings and psychological tests of personality were obtained as well as physical and operative data. Twenty-five percent developed a postcardiotomy delirium following a lucid interval and 6% an immediate organic brain syndrome apparent immediately on awakening from anesthesia.

It was suggested that postcardiotomy delirium be viewed as a psychosomatic syndrome. There was evidence that beyond the influence of physical and operative variables, a high degree of psychological activity and dominance may contribute to delirium. Further, a group seen by the research team had half the delirium incidence of a comparable group not seen, suggesting that such intervention has a prophylactic-therapeutic function. Prior investigations showing a relationship between delirium and physical and operative variables were confirmed.