The effect of clinical variables on distress and depressive symptoms among heart transplant recipients

Heart transplantation (HTx) is the standard treatment for end-stage cardiomyopathy and coronary artery disease. Although major improvements have been made in the prevention and treatment of acute graft rejection, comorbidities still limit the long-term survival of heart transplant recipients. The risk of poor outcome, such us major health status aggravation and death, can stimulate the occurrence of depression and stress in this population. The aim of this study was to determine the impact of comorbidities on depressive symptoms and distress among heart transplant recipients.

The sample included 131 HTx recipients from one site. Data were collected during a follow-up in-hospital appointment, using the questionnaires assessing depression (Beck Depression Inventory Short Form) and stress (Perceived Stress Scale-10). Statistical analyses included descriptive statistics, Pearson correlations, t-tests, and generalized linear models.

Study patients were 75.6% (n = 97) male, 100% (n = 131) Caucasian, 74% (n = 89) married, with the mean age of 54 years at time of heart transplantation. Nearly half of the participants (40.5%) presented depression symptoms at the time of evaluation. Severe stress was observed in 30% of individuals. Depression symptoms and severe distress were more commonly observed in patients with many comorbidities, requiring multiple drug therapy, and high NYHA score. Moreover, in a multivariate logistic regression, depression and high distress level occurrence were predicted by the following independent factors: cardiac allograft vasculopathy, cancer, diabetes, higher NYHA score, and comorbidities.

The prevalence of depression and severe distress is common among heart transplant recipients. Patients with many comorbidities are at higher risk of psychological indisposition.