title: Post-transplant outcome-clusters of psychological distress and health-related quality of life in lung transplant recipients.
abstract: OBJECTIVE
  To (1) assess distinct clusters of psychological distress and health-related quality of life during the first 6 months following lung transplantation; (2) identify patients with poor psychosocial outcomes; and (3) determine potential predictors regarding psychological distress and health-related quality (HRQoL) of life at 6 months post-transplant.
  
  
  METHODS
  A total of 40 patients were examined for psychological distress (Symptom Checklist short version-9) and quality of life (EuroQOL five-dimension health-related quality of life questionnaire) during their first 6 months post-transplant. Hierarchical cluster analyses were performed to identify specific types of post-transplant outcomes in terms of psychological distress and HRQoL over the first six post-transplant months. Correlational analyses examined medical and psychosocial predictors of the outcome at 6 months post-transplant.
  
  
  RESULTS
  Three distinctive clusters were identified, summarizing either groups of patients with (1) optimal (35%), (2) good (42%), and (3) poor outcome-clusters (23%). The latter tended to be older, to suffer from more severe disease, to have more co-morbidities, to have had a prolonged intensive care unit and/or hospital stay, to have more hospital admissions and were more frequently treated with antidepressants post-transplant. Disease severity, length of stay, quality of life two weeks post-transplant, hospital admissions and use of antidepressants were strong predictors of psychological distress and impaired health-related quality of life at six months of follow-up.
  
  
  CONCLUSIONS
  Almost a quarter of the investigated patients suffered from elevated distress and substantially impaired HRQoL, with no improvements over time. Results underscore the psychosocial needs of patients with poor post-transplant outcomes.
authors.affiliation: Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich, Switzerland.
authors.forename: Annina
authors.initials: A
authors.lastname: Seiler
authors.affiliation: Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich, Switzerland.
authors.forename: Josef
authors.initials: J
authors.lastname: Jenewein
authors.affiliation: Department of Psychology, University of Fribourg, Switzerland.
authors.forename: Chantal
authors.initials: C
authors.lastname: Martin-Soelch
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Segeberger Kliniken, Bad Segeberg, Germany.
authors.forename: Lutz
authors.initials: L
authors.lastname: Goetzmann
authors.affiliation: Department of Thoracic Surgery, University Hospital Zurich, Switzerland.
authors.forename: Ilhan
authors.initials: I
authors.lastname: Inci
authors.affiliation: Department of Thoracic Surgery, University Hospital Zurich, Switzerland.
authors.forename: Walter
authors.initials: W
authors.lastname: Weder
authors.affiliation: Division of Pulmonary Medicine, University Hospital Zurich, Switzerland.
authors.forename: Macé M
authors.initials: MM
authors.lastname: Schuurmans
authors.affiliation: Division of Pulmonary Medicine, University Hospital Zurich, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Benden
authors.affiliation: Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich, Switzerland.
authors.forename: Angela
authors.initials: A
authors.lastname: Brucher
authors.affiliation: Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich, Switzerland.
authors.forename: Richard
authors.initials: R
authors.lastname: Klaghofer
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology*; D013315:Stress, Psychological / Q000175:diagnosis*; D013557:Switzerland; D066027:Transplant Recipients / Q000523:psychology*; D055815:Young Adult