title: Nature and correlates of post-traumatic stress symptomatology in lung transplant recipients.
abstract: BACKGROUND
  The burden of post-traumatic stress disorder (PTSD) symptoms may be associated with worse outcomes after transplantation. Little is known about the prevalence and correlates of PTSD symptoms in lung transplant recipients.
  
  
  METHODS
  We conducted a cross-sectional study of lung transplant recipients between April 2008 and February 2010 at a single center. The PTSD Checklist was used to determine the burden of PTSD symptomatology (total score) and percent of subjects with a provisional PTSD diagnosis (validated algorithms). We assessed the relationship between PTSD symptom burden and patient characteristics with multivariable logistic modeling.
  
  
  RESULTS
  We enrolled 210 subjects (response rate 91%). Most patients were female (50%), and Caucasian (89%). The median age was 59 (interquartile range [IQR] 48 to 63) years and the median time between transplant and follow-up was 2.4 (IQR 0.7 to 5.3) years. Clinically significant PTSD symptomatology was observed in 12.6% (8.4% to 17.9%) of subjects. Subjects were more likely to endorse symptoms of re-experiencing (29.5%) and arousal (33.8%) than avoidant symptoms (18.4%). Multivariable linear regression showed higher PTSD symptom scores among recipients who were: younger (p < 0.001); without private insurance (p = 0.001); exposed to trauma (p < 0.001); or diagnosed with bronchiolitis obliterans syndrome (p = 0.005).
  
  
  CONCLUSIONS
  Overall prevalence of PTSD (12.6%) in our study was two times higher than the general population. Patient characteristics found to be associated with an increased burden of PTSD symptoms may be useful to consider in future interventions designed to reduce this comorbidity.
authors.affiliation: Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA. griescj@upmc.edu
authors.forename: Cynthia J
authors.initials: CJ
authors.lastname: Gries
authors.forename: Mary Amanda
authors.initials: MA
authors.lastname: Dew
authors.forename: J Randall
authors.initials: JR
authors.lastname: Curtis
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Edelman
authors.forename: Annette
authors.initials: A
authors.lastname: DeVito Dabbs
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Pilewski
authors.forename: Christopher H
authors.initials: CH
authors.lastname: Goss
authors.forename: Michael S
authors.initials: MS
authors.lastname: Mulligan
authors.forename: Douglas B
authors.initials: DB
authors.lastname: White
mesh_terms: D015897:Comorbidity; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D016040:Lung Transplantation / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology*