Depressive symptoms and all-cause mortality after heart transplantation.
BACKGROUND
Several studies indicate that heart transplantation (HTx) is associated with depression and reduced quality of life. However, the impact of depression on the prognosis for HTx-patients has not yet been sufficiently established. The aim of the present study was to prospectively investigate the influence of depression on mortality in patients with HTx, adjusting for other known risk factors.


METHODS
In a prospective, cross-sectional study with minimum 5-year follow-up, symptoms of depression were assessed in 147 HTx-patients using the Beck Depression Inventory (BDI).


RESULTS
Mild to severe depressive symptoms (BDI > or =10) were observed in 36 patients (24.5%). Depressive symptoms on inclusion increased the risk of mortality during the follow-up period. The risk remained significant after adjusting for several somatic and lifestyle risk factors, and the adjusted relative risk associated with depression (risk ratio: 2.32; 95% CI: 1.13-4.79; P=0.02) was comparable to the adjusted relative risk associated with time since HTx.


CONCLUSIONS
Symptoms of depression predict mortality independently of somatic and lifestyle risk factors in HTx patients, and this group of patients should be screened for depressive symptoms.
Havik
Odd E
OE
Department of Clinical Psychology, University of Bergen, Bergen, Norway. odd.havik@psykp.uib.no
Sivertsen
Borge
B
Relbo
Anne
A
Hellesvik
Marit
M
Grov
Ingelin
I
Geiran
Odd
O
Andreassen
Arne K
AK
Simonsen
Svein
S
Gullestad
Lars
L
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation / Q000401:mortality* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012306:Risk