title: Depression and Pain in Heart Transplant Recipients: An Observational Study.
abstract: Characterizing how physical and psychological symptoms interact in heart transplant recipients may lead to advances in therapeutic options. This study examined associations between pain and major depression.
  
  
  METHODS
  A cross-sectional study was conducted with adult heart transplant recipients. Pain was measured with the bodily pain domain of the Short Form-36 Health Survey and psychological distress with the Kessler Psychological Distress Scale (K-10). The Mini International Neuropsychiatric Interview, version 6.0, was used to identify participants meeting the criteria for major depression. Hierarchical linear regression was used to determine if there was an association between pain and major depression, controlling for pharmacological treatment of depression, severity of psychological distress, and clinical characteristics including immunosuppression medication which may induce pain as a side effect.
  
  
  RESULTS
  Average pain score of the 48 heart transplant recipients was 43 ( SD ± 10, range 0-100, lower scores indicate worse pain), with moderate pain reported by 39% ( n = 19). Major depression was associated with worse pain ( R2change = 36%, β = -16, 95% confidence interval [CI] = [-30, -4], p = .012). Pharmacological treatment for depression was associated with better pain scores ( R2change = 1.5%, β = 13, 95% CI [4, 23], p = .006).
  
  
  CONCLUSIONS
  Heart transplant recipients with major depression had worse pain after controlling for pharmacological treatment of depression, severity of psychological distress, and clinical characteristics. Thus, it is imperative that clinicians devising a treatment regimen for pain in heart transplant recipients take into account co-occurring depression and vice versa.
authors: 1 Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Australia.
authors: Aaron
authors: A
authors: Conway
authors: 2 School of Psychology, Queensland University of Technology, Kelvin Grove, Australia.
authors: Judith
authors: J
authors: Sheridan
authors: 3 Advanced Heart Failure and Transplant Unit, The Prince Charles Hospital, Chermside, Australia.
authors: Joanne
authors: J
authors: Maddicks-Law
authors: 4 Nursing Research and Practice Development Unit, The Prince Charles Hospital, Chermside, Australia.|5 School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Brisbane, Australia.
authors: Paul
authors: P
authors: Fulbrook
authors: 6 Centre for the Heart and Mind, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
authors: Chantal F
authors: CF
authors: Ski
authors: 6 Centre for the Heart and Mind, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
authors: David R
authors: DR
authors: Thompson
authors: 7 School of Nursing and Midwifery, Flinders University, Adelaide, Australia.
authors: Robyn A
authors: RA
authors: Clark
authors: 8 School of Nursing, University of California, Los Angeles, Los Angeles, CA, USA.
authors: Lynn V
authors: LV
authors: Doering
keywords: depression; pain; transplant