title: Psychological distress in patients with a left ventricular assist device and their partners: an exploratory study.
abstract: BACKGROUND
  Left ventricular assist device (LVAD) therapy is increasingly used in patients with advanced heart failure, and may have a significant psychological impact on both patients and their partners. Hence, we examined the distress levels of LVAD patients and their partners.
  
  
  METHODS
  Anxiety, depression and post-traumatic stress disorder (PTSD) were assessed at 3-4 weeks after implantation, and at 3 and 6 months follow-up in 33 LVAD patients (73% men; mean age=54±10 years) and 33 partners (27% men; mean age=54±11 years).
  
  
  RESULTS
  The prevalence of anxiety in LVAD partners was significantly higher compared to LVAD patients at baseline (48% vs. 23%, p=0.03) and 3 months follow-up (44% vs. 15%, p=0.02), but not at 6 months follow-up (p=0.43). No differences were found for depression and PTSD (ps>0.05). Scores between the LVAD patients and partners showed only a significant correlation at baseline between the anxiety, depression and PTSD score of the patient and the depression score of the partner (r anx=0.40, p=0.04; rdep=.40, p=0.04; r PSTD=0.46, p=0.05). Multivariable analyses showed no significant association between the role (patient vs. partner) and anxiety, depression and PTSD over time after correction for age, gender and clinical covariates. However, after correction for Type D personality and the use of psychotropic medication the LVAD partners showed significantly higher anxiety (F=6.95, p=0.01) and depression (F=3.94, p=0.04) scores over time compared to LVAD patients.
  
  
  CONCLUSIONS
  LVAD partners had significantly higher levels of anxiety than LVAD patients. Emotional distress of LVAD partners should gain more attention, as partners are an essential source of support for LVAD patients.
authors.affiliation: CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, The Netherlands.
authors.forename: Corline
authors.initials: C
authors.lastname: Brouwers
authors.affiliation: CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, The Netherlands.
authors.forename: Johan
authors.initials: J
authors.lastname: Denollet
authors.affiliation: Erasmus Medical Center, Department of Cardiology, Thoraxcenter, The Netherlands.
authors.forename: Kadir
authors.initials: K
authors.lastname: Caliskan
authors.affiliation: University Medical Center, Division Heart and Lung, The Netherlands.
authors.forename: Nicolaas
authors.initials: N
authors.lastname: de Jonge
authors.affiliation: Erasmus Medical Center, Department of Cardiology, Thoraxcenter, The Netherlands.
authors.forename: Alina
authors.initials: A
authors.lastname: Constantinescu
authors.affiliation: St. Paul's Hospital, Heart Center, Canada.
authors.forename: Quincy
authors.initials: Q
authors.lastname: Young
authors.affiliation: St. Paul's Hospital, Heart Center, Canada.
authors.forename: Annemarie
authors.initials: A
authors.lastname: Kaan
authors.affiliation: CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, The Netherlands sspedersen@health.sdu.dk.
authors.forename: Susanne S
authors.initials: SS
authors.lastname: Pedersen
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000209:etiology / Q000503:physiopathology; D016009:Chi-Square Distribution; D003866:Depressive Disorder / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D006353:Heart-Assist Devices / Q000009:adverse effects* / Q000523:psychology*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D018570:Risk Assessment; D012720:Severity of Illness Index; D018454:Spouses / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology / Q000503:physiopathology; D013315:Stress, Psychological / Q000209:etiology / Q000503:physiopathology; D015996:Survival Rate; D013997:Time Factors
keywords: LVAD; PTSD; anxiety; depression; health status; partner