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Atrial fibrillation and psychological factors: a systematic review

BACKGROUND: Psychological factors have been suggested to have an influence in Atrial Fibrillation (AF) onset, progression, severity and outcomes, but their role is unclear and mainly focused on anxiety and depression. METHODS: A systematic electronic search had been conducted to identify studies exp...

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Autores principales: Galli, Federica, Borghi, Lidia, Carugo, Stefano, Cavicchioli, Marco, Faioni, Elena Maria, Negroni, Maria Silvia, Vegni, Elena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: PeerJ Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5555290/
https://www.ncbi.nlm.nih.gov/pubmed/28828233
http://dx.doi.org/10.7717/peerj.3537
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author Galli, Federica
Borghi, Lidia
Carugo, Stefano
Cavicchioli, Marco
Faioni, Elena Maria
Negroni, Maria Silvia
Vegni, Elena
author_facet Galli, Federica
Borghi, Lidia
Carugo, Stefano
Cavicchioli, Marco
Faioni, Elena Maria
Negroni, Maria Silvia
Vegni, Elena
author_sort Galli, Federica
collection PubMed
description BACKGROUND: Psychological factors have been suggested to have an influence in Atrial Fibrillation (AF) onset, progression, severity and outcomes, but their role is unclear and mainly focused on anxiety and depression. METHODS: A systematic electronic search had been conducted to identify studies exploring different psychological factors in AF. The search retrieved 832 articles that were reviewed according to inclusion criteria: observational study with a control/comparison group; use of standardized and validated instruments for psychological assessment. Results were summarized qualitatively and quantitatively by effect size measure (Cohen’s d and its 95% confidence interval). Cochrane Collaboration guidelines and the PRISMA Statement were adopted. RESULTS: Eight studies were included in the systematic review. Depression was the most studied construct/ but only one study showed a clear link with AF. The remaining studies showed small and non-significant (95% CI [−0.25–1.00]) differences between AF and controls, no differences in frequency of depression history (95% CI [−0.14–0.22]) or in case frequency (95% CI [−0.50–0.04]). Miscellaneous results were found as far as anxiety: AF patients showed higher levels when compared to healthy subjects (95% CI [2.05–2.95]), but findings were inconsistent when compared to other heart diseases. Considering personality and life-events preceding AF, we respectively found a large (95% CI [1.87–2.49]) and a moderate to large effect (95% CI [0.48–0.98]). DISCUSSION: The small number of studies does not allow to draw clear-cut conclusions on the involvement of psychological factors in AF. Promising lines of research are related to personality and adverse life-events, and to the increase of longitudinal design studies. Some methodological problems could be overcome by including clinical psychologists in the implementation of research protocols.
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spelling pubmed-55552902017-08-21 Atrial fibrillation and psychological factors: a systematic review Galli, Federica Borghi, Lidia Carugo, Stefano Cavicchioli, Marco Faioni, Elena Maria Negroni, Maria Silvia Vegni, Elena PeerJ Cardiology BACKGROUND: Psychological factors have been suggested to have an influence in Atrial Fibrillation (AF) onset, progression, severity and outcomes, but their role is unclear and mainly focused on anxiety and depression. METHODS: A systematic electronic search had been conducted to identify studies exploring different psychological factors in AF. The search retrieved 832 articles that were reviewed according to inclusion criteria: observational study with a control/comparison group; use of standardized and validated instruments for psychological assessment. Results were summarized qualitatively and quantitatively by effect size measure (Cohen’s d and its 95% confidence interval). Cochrane Collaboration guidelines and the PRISMA Statement were adopted. RESULTS: Eight studies were included in the systematic review. Depression was the most studied construct/ but only one study showed a clear link with AF. The remaining studies showed small and non-significant (95% CI [−0.25–1.00]) differences between AF and controls, no differences in frequency of depression history (95% CI [−0.14–0.22]) or in case frequency (95% CI [−0.50–0.04]). Miscellaneous results were found as far as anxiety: AF patients showed higher levels when compared to healthy subjects (95% CI [2.05–2.95]), but findings were inconsistent when compared to other heart diseases. Considering personality and life-events preceding AF, we respectively found a large (95% CI [1.87–2.49]) and a moderate to large effect (95% CI [0.48–0.98]). DISCUSSION: The small number of studies does not allow to draw clear-cut conclusions on the involvement of psychological factors in AF. Promising lines of research are related to personality and adverse life-events, and to the increase of longitudinal design studies. Some methodological problems could be overcome by including clinical psychologists in the implementation of research protocols. PeerJ Inc. 2017-08-11 /pmc/articles/PMC5555290/ /pubmed/28828233 http://dx.doi.org/10.7717/peerj.3537 Text en ©2017 Galli et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, reproduction and adaptation in any medium and for any purpose provided that it is properly attributed. For attribution, the original author(s), title, publication source (PeerJ) and either DOI or URL of the article must be cited.
spellingShingle Cardiology
Galli, Federica
Borghi, Lidia
Carugo, Stefano
Cavicchioli, Marco
Faioni, Elena Maria
Negroni, Maria Silvia
Vegni, Elena
Atrial fibrillation and psychological factors: a systematic review
title Atrial fibrillation and psychological factors: a systematic review
title_full Atrial fibrillation and psychological factors: a systematic review
title_fullStr Atrial fibrillation and psychological factors: a systematic review
title_full_unstemmed Atrial fibrillation and psychological factors: a systematic review
title_short Atrial fibrillation and psychological factors: a systematic review
title_sort atrial fibrillation and psychological factors: a systematic review
topic Cardiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5555290/
https://www.ncbi.nlm.nih.gov/pubmed/28828233
http://dx.doi.org/10.7717/peerj.3537
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