PREVALENCE AND PREDICTORS OF DEPRESSION AND ANXIETY-RELATED DISORDERSDURING THE YEAR AFTER HEART-TRANSPLANTATION

This study longitudinally evaluated prevalence, clinical characteristi cs, and risk factors for DSM-III-R Major Depression, Generalized Anxie ty Disorder (GAD), associated Adjustment Disorders, and Post-Traumatic Stress Disorder related to the transplant (PTSD-T) in a large, repres entative sample of heart recipients followed during the first year aft er transplantation. Lifetime pretransplant prevalence as well as 1-yea r posttransplant rates were determined for the 154 recipients via stan dardized clinical interview schedules. Major Depression was the most p revalent disorder posttransplant (1-year rate of 17.3%), followed by P TSD-T (13.7%), and Adjustment Disorders (10.0%). There were no cases o f GAD. Specific pretransplant and perioperative factors increased reci pients' risk for any psychiatric disorder (vs none) posttransplant, in cluding pretransplant psychiatric history; poor social supports from p rimary family caregiver, other relatives, and friends; the use of avoi dance coping strategies for managing health problems; and low self-est eem early posttransplant. Within diagnostic groups, additional risk fa ctors distinguished recipients with anxiety-related vs depressive diso rders posttransplant: those at highest relative risk for anxiety had w aited more briefly for a donor heart, were more likely to have a famil y psychiatric history, had the poorest family and friend support of al l recipients, utilized the poorest coping skills, and had a poor sense of mastery. The findings have implications for the development of pri mary and secondary prevention strategies for psychiatric disorder in h eart recipient populations. (C) 1996 Elsevier Science Inc.