Psychiatric Morbidity and Associated Psychosocial Features in Heart Transplant Recipients

Background and purpose: The present study aimed to investigate psychiatric morbidity and associated psychosocial features in heart transplant recipients. Methods: The subjects comprised prior to the study. Experienced psychiatrists conducted an in-depth interview of each patient and psychiatric diagnoses were made in accordance with DSM-IV. In addition, a series of standardized reliable self-rating scales were used to assess the severity of psychopathology (Brief Symptom Rating Scale, BSRS), personality traits (modified Maudsley Personality Inventory MPI), family function (Family APGAR Index) and coping strategies. Results: the subjects were interviewed at a mean of 48.3 months (48.3 ± 12.9 months) after transplantation. They were all with good cardiac function condition (New York Heart Association (NYHA) class I). The employment rate was higher than in the pretransplant period (22.4% vs. 48.7%). Psychiatric illness was diagnosed in 12% of subjects based on the findings of the psychiatric interview. Comparison of the results of the general severity index (GSI) of BSRS in heart transplant recipients with normative GSI data obtained from medically ill inpatients without a formal diagnosis of psychiatric disorder revealed no significant difference. In total, 11.8% of the subjects manifested significant psychiatric morbidity based on GSI scores. The prevalence of marked psychiatric symptoms as measured by the BSRS included: phobia (21.1%), hostility (17.1%), depression (14.5%) and obsession (13.2%). Four psychosocial features, namely, “neuroticism”, “avoidance-withdrawal”, “fatalism-resignation” and “attention-shifting” accounted for 62% of the total variance in the severity of psychopathology based on GSI of BSRS. Conclusion: In this study, 88% of the survivors of heat transplantation were free from psychiatric morbidity. However, subjects with a higher score of neuroticism and those who more frequently used immature coping had a significantly increased risk of developing psychiatric morbidity.