title: Posttraumatic stress disorder and depression in heart transplantation recipients: the relationship with outcome and adherence to medical treatment.
abstract: 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.
  
  
  METHODS
  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.
authors.affiliation: Department of Neurosciences, University of Padua, Padova, Italy. angela.favaro@unipd.it
authors.forename: Angela
authors.initials: A
authors.lastname: Favaro
authors.forename: Gino
authors.initials: G
authors.lastname: Gerosa
authors.forename: Alida L P
authors.initials: AL
authors.lastname: Caforio
authors.forename: Biancarosa
authors.initials: B
authors.lastname: Volpe
authors.forename: Giampietro
authors.initials: G
authors.lastname: Rupolo
authors.forename: Deborah
authors.initials: D
authors.lastname: Zarneri
authors.forename: Silvia
authors.initials: S
authors.lastname: Boscolo
authors.forename: Chiara
authors.initials: C
authors.lastname: Pavan
authors.forename: Elena
authors.initials: E
authors.lastname: Tenconi
authors.forename: Chiara
authors.initials: C
authors.lastname: d'Agostino
authors.forename: Monica
authors.initials: M
authors.lastname: Moz
authors.forename: Gianluca
authors.initials: G
authors.lastname: Torregrossa
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Feltrin
authors.forename: Antonio
authors.initials: A
authors.lastname: Gambino
authors.forename: Paolo
authors.initials: P
authors.lastname: Santonastaso
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D005544:Forecasting; D016027:Heart Transplantation / Q000523:psychology*; D006801:Humans; D007406:Interview, Psychological; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance; D011446:Prospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology; D055815:Young Adult