The association between mood, anxiety and adjustment disorders and hospitalization following lung transplantation.
Psychiatric comorbidities such as mood, anxiety and adjustment disorders are common among individuals seeking lung transplantation. The objective of this study is to describe the association between these disorders and length of initial hospitalization and number of hospitalizations in the first year following transplantation.



This was a retrospective cohort study of all lung transplantation patients between January 1, 2008 and July 1, 2014 at a large academic center. We evaluated whether pretransplantation mood, anxiety or adjustment disorders were associated with length and number of hospitalizations after transplant, adjusting for age, sex, native disease, forced expiratory volume in 1 s prior to transplantation, wait list time and lung allocation score.



There were 185 patients who underwent transplantation during the 7.5-year study period of whom 125 (67.6%) had a mood, anxiety or adjustment disorder. Patients with an adjustment disorder had decreased length of initial hospitalization [B coefficient=-5.76; 95% confidence interval (CI)=-11.40 to -0.13; P=.04]. Patients with anxiety disorders had an increased number of hospitalizations in the first year following transplantation (rate ratio=1.41; 95% CI=1.06-1.88; P=.02). There was no association between mood disorders and length or number of hospitalizations. Mood, adjustment and anxiety disorders were not associated with time to initial rehospitalization.



Among the three most common pretransplantation psychiatric disorders, only anxiety disorders are associated with increased hospitalization in the first year following lung transplant. Interventions designed to better control pretransplantation and posttransplantation anxiety may be associated with less frequent hospitalization.
Division of Pulmonary and Critical Care, Brigham and Women's Hospital, Boston, MA, USA.
Andrew M
AM
Courtwright
Social Work, Care Coordination, Brigham and Women's Hospital, Boston, MA, USA.
Stacey
S
Salomon
Department of Medicine, Brigham and Women's Hospital; Department of Health Policy and Management, Harvard T. H. Chan School of Public Health; and Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
Lisa Soleymani
LS
Lehmann
Department of Pediatrics, Kaiser Permanente, Northern California, CA, USA.
Talya
T
Brettler
Division of Pulmonary and Critical Care, Brigham and Women's Hospital, Boston, MA, USA.
Miguel
M
Divo
Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Phillip
P
Camp
Division of Pulmonary and Critical Care, Brigham and Women's Hospital, Boston, MA, USA.
Hilary J
HJ
Goldberg
Department of Psychiatry, Harvard Medical School, Boston, MA, USA. Electronic address: dwolfe@partners.org.
David J
DJ
Wolfe
D000275:Adjustment Disorders / Q000453:epidemiology*; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D016040:Lung Transplantation / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology*; D012189:Retrospective Studies
Adjustment disorder; Anxiety; Depression; Hospitalization; Lung transplantation