{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T01:17:02Z","timestamp":1792199822670,"version":"4.4.0"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2018,9,18]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              An association between atrial fibrillation (\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              ), anxiety, and depression is recognized, but the spectrum of psychological distress remains unclear. We aimed to characterize the severity and predictors of distress associated with\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              in a tertiary population and its response to\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              management.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Seventy\u2010eight patients with symptomatic\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              underwent evaluation, including of\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              symptom severity, health\u2010related quality of life, psychological distress, suicidal ideation, and specific personality traits. Twenty participants\u00a0underwent\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              ablation and 58 were managed medically, with repeat assessments at 4, 8, and 12\u00a0months. Severe distress (Hospital Anxiety and Depression Scale score, \u226515\/42) was identified in 27 of 78 (35%). Independent predictors were a personality marked by vulnerability to stress (Perceived Stress Scale:\n              <jats:italic>R<\/jats:italic>\n              <jats:sup>2<\/jats:sup>\n              , 0.54; \u03b2=0.7\u00b10.1; t=7.8;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and 1 marked by negativity\/social inhibition (Type D Personality Scale:\n              <jats:italic>R<\/jats:italic>\n              <jats:sup>2<\/jats:sup>\n              , 0.47; \u03b2=0.7\u00b10.1; t=6.7;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Suicidal ideation was reported by 16 of 78 (20%) and was predicted by personality traits (Perceived Stress Scale score:\n              <jats:italic>R<\/jats:italic>\n              <jats:sup>2<\/jats:sup>\n              , 0.35; odds ratio, 1.22\u00b10.06;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001; Type D Personality Scale score:\n              <jats:italic>R<\/jats:italic>\n              <jats:sup>2<\/jats:sup>\n              , 0.48; odds ratio, 1.43\u00b10.14;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Effective\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              ablation (median\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              burden 1% [0\u20131%] over 12\u00a0months) was associated with significant reductions in distress (Hospital Anxiety and Depression Scale score, 13.9\u00b11.8 to 4.3\u00b11.8;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.05) and prevalence of suicidal ideation (30\u20135%;\n              <jats:italic>P<\/jats:italic>\n              =0.02).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              There was a high prevalence of severe psychological distress (35%) and of suicidal ideation (20%) in a tertiary\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              population, with personality traits predicting both. Effective\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              ablation was associated with significant improvements, suggesting\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              itself may be a treatable causative factor of distress.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.117.005502","type":"journal-article","created":{"date-parts":[[2018,9,18]],"date-time":"2018-09-18T09:00:12Z","timestamp":1537261212000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":62,"title":["Psychological Distress and Suicidal Ideation in Patients With Atrial Fibrillation: Prevalence and Response to Management Strategy"],"prefix":"10.1161","volume":"7","author":[{"given":"Tomos E.","family":"Walters","sequence":"first","affiliation":[{"name":"The Department of Cardiology Royal Melbourne Hospital Melbourne Australia"},{"name":"The Department of Medicine University of Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Wick","sequence":"additional","affiliation":[{"name":"The Centre for Women's Mental Health Royal Women's Hospital Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Tan","sequence":"additional","affiliation":[{"name":"The Department of Cardiology Royal Melbourne Hospital Melbourne Australia"},{"name":"The Department of Medicine University of Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Mearns","sequence":"additional","affiliation":[{"name":"The Department of Cardiology Royal Melbourne Hospital Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen A.","family":"Joseph","sequence":"additional","affiliation":[{"name":"The Department of Cardiology Royal Melbourne Hospital Melbourne Australia"},{"name":"The Department of Cardiology Western Health Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph B.","family":"Morton","sequence":"additional","affiliation":[{"name":"The Department of Cardiology Royal Melbourne Hospital Melbourne Australia"},{"name":"The Department of Medicine University of Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prashanthan","family":"Sanders","sequence":"additional","affiliation":[{"name":"The Centre for Heart Rhythm Disorders South Australian Health and Medical Research Institute University of Adelaide Australia"},{"name":"The Royal Adelaide Hospital Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Bryant","sequence":"additional","affiliation":[{"name":"The School of Psychological Sciences University of Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter M.","family":"Kistler","sequence":"additional","affiliation":[{"name":"The Department of Medicine University of Melbourne Australia"},{"name":"The Department of Cardiology Alfred Hospital and Baker IDI Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan M.","family":"Kalman","sequence":"additional","affiliation":[{"name":"The Department of Cardiology Royal Melbourne Hospital Melbourne Australia"},{"name":"The Department of Medicine University of Melbourne 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