Prevalence and predictors of depression and anxiety-related disorders during the year after heart transplantation.

Abstract

This study longitudinally evaluates prevalence, clinical characteristics, and risk factors for DSM-III-R Major Depression, Generalized Anxiety Disorder (GAD), associated Adjustment Disorders, and Post-Traumatic Stress Disorder related to the transplant (PTSD-T) in a large, representative sample of heart recipients followed during the first year after transplantation. Lifetime pretransplant prevalence as well as 1-year posttransplant rates were determined for the 154 recipients via standardized clinical interview schedules. Major Depression was the most prevalent disorder posttransplant (1- year rate of 17.3%), followed by PTSD-T (13.7%), and Adjustment Disorders (10.0%). There were no cases of GAD. Specific pretransplant and perioperative factors increased recipients' risk for any psychiatric disorder (vs none) posttransplant, including pretransplant psychiatric history; poor social supports from primary family caregiver, other relatives, and friends; the use of avoidance coping strategies for managing health problems; and low self-esteem early posttransplant. Within diagnostic groups, additional risk factors distinguished recipients with anxiety-related vs depressive disorders posttransplant: those at highest relative risk for anxiety had waited more briefly for a donor heart, were more likely to have a family psychiatric history, had the poorest family and friend support of all recipients, utilized the poorest coping skills, and had a poor sense of mastery. The findings have implications for the development of primary and secondary prevention strategies for psychiatric disorder in heart recipient populations.

• Authors: M A Dew, L H Roth, H C Schulberg, R G Simmons, R L Kormos, P T Trzepacz, B P Griffith
• Journal: General hospital psychiatry (Gen Hosp Psychiatry) Vol. 18 Issue 6 Suppl Pg. 48S-61S (Nov 1996) ISSN: 0163-8343 [Print] United States
• PMID: 8937923 (Publication Type: Journal Article, Research Support, U.S. Gov't, P.H.S.)

Topics

• Adaptation, Psychological
• Adult
• Aged
• Anxiety Disorders (etiology)
• Depressive Disorder (etiology)
• Female
• Heart Transplantation (adverse effects)
• Humans
• Longitudinal Studies
• Male
• Middle Aged
• Predictive Value of Tests
• Prevalence
• Psychiatric Status Rating Scales
• Risk Factors
• Self Concept
• Social Support
• Stress Disorders, Post-Traumatic (etiology)