Beyond rose colored glasses: the adaptive role of depressive and anxious symptoms among individuals with heart failure who were evaluated for transplantation

Abstract

The prospect of and the evaluative period for transplantation can be stressful for individuals with heart failure (HF). Little is known about the impact of psychosocial factors on service utilization and health outcomes. The current study examined the impact of depression, dysthymia, and anxiety on two-yr hospitalization and mortality among 96 individuals with HF who were evaluated for transplantation. Results revealed that only a small percentage of individuals endorsed sufficient symptomatology to meet criteria for a psychiatric, Axis I disorder (3.1% = anxiety; 2.1% = depression; 1.0% = dysthymia) although a significant proportion of the sample was prescribed an antidepressant or an anxiolytic (37%). Multivariable regression analysis was conducted to examine the association between significant independent demographic, medical, and psychiatric predictors and total duration of hospitalizations; logistic regression analysis was used to examine the relation between predictors and mortality. An increase in anxious symptoms was associated with a decrease in total number of days hospitalized during the two-yr period following the initial evaluation. Similarly, as depressive symptoms increased, risk of two-yr mortality decreased. Future research should assess communication between the patient and providers to further elucidate the potential relationship between psychiatric symptoms, service utilization/hospitalization, and mortality in this patient population.

Neurocognitive status is associated with all-cause mortality among psychiatric, high-risk liver transplant candidates and recipients

“…47 found worse outcomes, and Madan et al. 48 found better outcomes among heart transplant patients with psychiatric symptoms. In examining liver transplant recipients, Singh et al.…”

“…In general, the association between premorbid psychosocial functioning and transplant outcomes is mixed. 13 For example, whereas Skotzko et al 46 found no difference, Zipfel et al 47 found worse outcomes, and Madan et al 48 found better outcomes among heart transplant patients with psychiatric symptoms. In examining liver transplant recipients, Singh et al 49 found that pretransplant depression did not influence one-and six-month survival, but individuals with significant depressive symptoms evinced higher mortality while awaiting transplantation than individuals without significant depressive symptoms.…”

Palliative Care in Heart Transplantation

“…Providers should be aware that transplant candidates may be concerned about disclosure of mental health concerns due to fear of the effect on transplant candidacy. 10 Referral to mental health providers should be done as needed, not only during the transplant evaluation but during the wait for transplant. Finally, a controversial topic is the discussion with transplant candidates regarding do-not-resuscitate (DNR) status.…”

Anxiety, Depression and Coronary Artery Disease among Patients Undergoing Angiography in Ghaem Hospital, Mashhad, Iran

“…Mood state may lead to hospitalization even after correction for demographic and medical factors [6]. Many studies have reported that mood disorders have an important impact on the outcome of cardiac transplantation; depressed patients with heart transplant have a tendency to be less active than those without [15] [16]. Social support is an important factor of psychology and it is useful for influence on heart, for example, patients with heart failure who are unmarried or seldom visit their family or friends have a significantly higher risk of serious impairment in activities [6].…”