Posttraumatic stress disorder and depression in heart transplantation recipients: the relationship with outcome and adherence to medical treatment

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• 作者：Angela Favaro M.D. ; Ph.D.^a ; ^{angela.favaro@unipd.it} ; Gino Gerosa M.D.^b ; Alida L.P. Caforio M.D.^b ; Biancarosa Volpe M.Sc.^b ; Giampietro Rupolo M.D.^c ; Deborah Zarneri B.Sc.^b ; Silvia Boscolo B.Sc.^b ; Chiara Pavan M.D. ; Ph.D.^a ; Elena Tenconi Ph.D.^a ; Chiara d'Agostino M.D.^b ; Monica Moz M.D.^b ; Gianluca Torregrossa M.D.^b ; Giuseppe Feltrin M.D.^b ; Antonio Gambino M.D.^b ; Paolo Santonastaso M.D.^a
• 关键词：PTSD ; Heart transplantation ; Major depression ; Compliance ; Mortality ; Cancer
• 刊名：General Hospital Psychiatry
• 出版年：2011
• 出版时间：January-February 2011
• 年：2011
• 卷：33
• 期：1
• 页码：1-7
• 全文大小：165 K

文摘

Objective

There is growing evidence of the importance of psychiatric risk factors for predicting the outcome of heart transplantation (HT) recipients. The aim of our study was to investigate the role of major depression and posttraumatic stress disorder (PTSD) in the prediction of the outcome of HT in a consecutive sample of 107 recipients.

Method

All subjects of the study underwent a structured diagnostic interview for assessing the presence of pretransplant and posttransplant major depression and transplantation-related PTSD 1 to 5 years after HT. The adherence to medical treatment was assessed some months after the structured interview. The medical outcome (acute rejections, cancer, mortality) was followed up for 8 years on average after the interview, using a prospective design.

Results

Estimated frequency of psychiatric diagnoses after HT was 12 % for transplantation-related PTSD and 41 % for major depression. The presence of an episode of major depression prior to HT is a significant independent risk factor for posttransplant malignancies. Age, posttransplant malignancies and poor adherence are significant predictors of mortality in the survival analyses.

Conclusions

The present study highlights the importance of the assessment of psychosocial variables and psychiatric diagnoses before and after transplantation in HT recipients. Our findings have important clinical implications and require replication with larger samples.