title: Personality predictors of mortality in cardiac transplant candidates and recipients.
abstract: OBJECTIVE
  Emotional factors are generally recognized as impacting the care of end-stage heart disease and mortality following cardiac transplants. Equally important, however, are predictors of pretransplant mortality. The current study examined the utility of the Millon Behavioral Health Inventory (MBHI) as a predictor of pre- and posttransplant mortality.
  
  
  METHODS
  A total of 103 cardiac transplant candidates were assessed with the MBHI as part of a pretransplant evaluation that included baseline demographic variables and cardiac status. Time to transplant and mortality status at 1 and 5 years was also obtained.
  
  
  RESULTS
  Cluster analysis of MBHI response scores elicited two clusters characterized by high and low distress. Cluster membership predicted survival status at 1-year and 5-year follow-up, with high distress cluster patients having significantly higher mortality in both the total sample and a subgroup of patients who did receive a heart transplant.
  
  
  CONCLUSIONS
  These results support the value of the MBHI for assessing personality attributes that may dispose toward unfavorable outcome in heart transplant candidates. Further understanding of psychosocial contributions to illness course and outcome may enable more effective selection of treatment interventions with cardiac patients.
authors.affiliation: Psychiatry Department, University of Michigan Health Systems, 475 Market Place, Suite L, Ann Arbor, MI 48108, USA.
authors.forename: M
authors.initials: M
authors.lastname: Brandwin
authors.forename: P C
authors.initials: PC
authors.lastname: Trask
authors.forename: S M
authors.initials: SM
authors.lastname: Schwartz
authors.forename: M
authors.initials: M
authors.lastname: Clifford
mesh_terms: D016000:Cluster Analysis; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation / Q000401:mortality* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010551:Personality; D010552:Personality Assessment; D011446:Prospective Studies; D013315:Stress, Psychological / Q000523:psychology; D015996:Survival Rate; D013997:Time Factors