Posttraumatic stress disorder after implantation of a Mechanical Assist Device Followed by Heart Transplantation: Evaluation of Patients and Partners

Bunzel, Brigitta; Laederach‐Hofmann, Kurt; Wieselthaler, Georg; Roethy, Wilfried; Drees, G.

doi:10.1016/j.transproceed.2004.12.248

Cited by 59 publications

(60 citation statements)

References 26 publications

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“…30 The prevalence rates of anxiety and depression varied widely across the 6 studies that included a semistructured diagnostic interview using Diagnostic and Statistical Manual of Mental Disorders (4th Edition) criteria, the Symptom Checklist-90, the Beck Depression Inventory, or the Mini-Mental State Examination (Table 2). Some studies found that only 2% of LVAD patients experienced depression and only 4% experienced anxiety, 20 whereas others found a considerable group of LVAD patients experiencing a depressive or adjustment disorder (21% and 37%-50%, respectively). 29,31 In trials (ie, the Randomized Evaluation of Mechanical Assistance in the Treatment of Congestive Heart Failure trial) comparing LVAD patients using pulsatile devices with patients using optimal medical treatment and transplant recipients, LVAD support was associated with a significant improvement in health status and depressive symptoms in contrast to medication alone (PϽ0.05 for both).…”

Section: Brouwers Et Almentioning

confidence: 99%

“…Patients supported by pulsatile devices showed relatively high mean depression scores just after LVAD implantation. 26,29,31 The retrospective study 19 of Bunzel et al 20 found no significant difference in depression scores between patients receiving therapy via pulsatile vs continuous-flow devices; these patients might be more vulnerable to psychological distress, based on the higher rate of complications and the characteristics of the device (eg, short durability, large size, noise, and large batteries). Hence, these differences in findings could well be explained by sample size limitations, differences in subtype of devices, and the time of collecting data.…”

Section: Summary Of the Findingsmentioning

confidence: 99%

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Patient-Reported Outcomes in Left Ventricular Assist Device Therapy

Brouwers

Denollet

Jonge

et al. 2011

Circ: Heart Failure

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Patient-reported outcomes in left ventricular assist device therapyBrouwers, C.J.; Denollet, J.; de Jonge, N.; Caliskan, K.; Kealy, J.; Pedersen, S.S. General rightsCopyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.-Users may download and print one copy of any publication from the public portal for the purpose of private study or research -You may not further distribute the material or use it for any profit-making activity or commercial gain -You may freely distribute the URL identifying the publication in the public portal Take down policyIf you believe that this document breaches copyright, please contact us providing details, and we will remove access to the work immediately and investigate your claim. Background-Technological advancements of left ventricular assist devices (LVAD) have created today's potential for extending the lives of patients with end-stage heart failure. Few studies have examined the effect of LVAD therapy on patient-reported outcomes (PROs), such as health status, quality of life, and anxiety/depression, despite poor PROs predicting mortality and rehospitalization in patients with heart failure. In this systematic review, we provide an overview of available evidence on the impact of LVAD therapy on PROs and discuss recommendations for clinical research and practice. Methods and Results-A systematic literature search identified 16 quantitative studies with a sample size Ն10 (meanϮSD ageϭ50.1Ϯ12.6 years) that examined the impact of LVAD therapy on PROs using a quantitative approach. Initial evidence suggests an improvement in health status, anxiety, and depression in the first few months after LVAD implantation. However, PRO scores of patients receiving LVAD therapy are still lower for physical, social, and emotional functioning compared with transplant recipients. These studies had several methodological shortcomings, including the use of relatively small sample sizes, and only a paucity of studies focused on anxiety and depression. Conclusions-There is a paucity of studies on the patient perspective of LVAD therapy. To advance the field of LVAD research and to optimize the care of an increasingly growing population of patients receiving LVAD therapy, more well-designed large-scale studies are needed to further elucidate the impact of LVAD therapy on PROs. (Circ Heart Fail. 2011;4:714-723.)Key Words: left ventricular assist device Ⅲ patient-reported outcomes Ⅲ quality of life Ⅲ review

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Section: Brouwers Et Almentioning

confidence: 99%

Section: Summary Of the Findingsmentioning

confidence: 99%

Patient-Reported Outcomes in Left Ventricular Assist Device Therapy

Brouwers

Denollet

Jonge

et al. 2011

Circ: Heart Failure

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“…In the transplant literature 'distress' refers to psychiatric diagnosis such as depression, anxiety and psychosis (Abbott, Agodoa, & Malley, 2003;Brosig & Woidera, 1993;Bunzel, Wollenek, & Grundbock, 1990;Bunzel et al, 2005, Evangelista, Doering, Dracup, Vassilakis, & Kobashigawa, 2003Laederach-Hofmann, Begre, & Bunzel, 2002;Salvucci, 2004;Triffaux, Demoulin, & Limet, 2002). Case studies of heart recipients report otherwise inexplicable psychiatric conditions post-transplant, including "night-time anxiety, feelings of suffocation" (Brosig & Woidera, 1993, "organ related fantasies" (Laederach-Hofmann et al, 2002, "delirium" (Triffaux et al, 2002), and "psychosomatic hyperventilation syndrome" (Bunzel et al, 1990).…”

Section: Adult Transplant Recipientsmentioning

confidence: 99%

The New Normal: A Bourdieusian Examination of Living Into Young Adulthood Being a Paediatric Heart Transplant Recipient

Mauthner

Angus

Gastaldo

et al. 2014

The Journal of Heart and Lung Transplantation

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Improved success of paediatric cardiac transplantation has resulted in increased survival of recipients into young adulthood (19 to 29 years of age). Young adults who received a heart transplant during childhood have experienced multiple life sustaining procedures. As survival and longevity increase, it is clear that transplant recipients experience negative physiological, psychological and social sequelae. With heart transplant offering individuals a chance to extend life into young adulthood, recipients need lifelong care and at age 18 they will transition from paediatric to adult healthcare facilities. The study addressed young adults circumstances of existence and their competing interests within various social environments. This research project applied Pierre Bourdieu's theoretical concepts of habitus, field and capital, to conceptualize and engage with empirical knowledge production about young adults who have received a heart transplant during childhood. Using visual methodology, focused open-ended interviews were conducted with 12 young adults who had a heart transplant during childhood. Bourdieu's work iii provided a theoretical framework to investigate transplant recipients' identities and social repositioning in relation to dominant discourses of organ transplant and shifting relationships with health services providers. This study involved an iterative process to identify recipients' encounters and new compositions in relation with others, in order to answer the research objective. These findings highlight that young adult transplant recipients struggle with relational dispositions that excludes them from various fields of social engagement; their struggle and exclusion from various fields is symbolic and is embedded in the structure of the dominant social order of the field from where they become excluded; the social order is taken up and embodied, leading young transplant recipients to practices of accommodation and "normalization". Changes

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“…Relapse to alcohol and drug use is reported at 27%. Dietary noncompliance is reported at 18%, but is probably much higher, with more than 50% of recipients overweight, and 20% morbidly obese (BMI [ 30), increasing the risk for CAD, hypertension, and diabetes. Although exercise can prevent immunosuppression-related adverse effects such as steroid-induced osteoporosis and myopathy, 13-72% do not exercise as directed [17].…”

Section: Psychiatric Morbidity Predicts Poor Healthmentioning

confidence: 99%

“…Psychiatric diagnoses by DSMIV criteria included adjustment reaction in 50%, of patients, delirium in 21%, depression NOS in 14%, major depression (MDD) in 7%, brief psychosis in 7%, and dissociative disorder in 7%. One study [30] in a sample of 41 patients with a variety of devices, and time on LVAD ranging from 28 to 711 days, found no post-traumatic stress disorder.…”

Section: Medical and Neuropsychological Complications After Lvadmentioning

confidence: 99%

LVAD destination therapy: applying what we know about psychiatric evaluation and management from cardiac failure and transplant

et al. 2008

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Left ventricular assist devices (LVADs) have evolved into long-term use as destination therapy for those with severe end-stage heart failure due to other medical risks. Success with LVAD depends on adherence to a complicated mechanical regimen, and acceptance of a life that is far from normal. Patients with LVADs share characteristics with other end-stage cardiac failure patients and those waiting for or receiving heart transplants. Understanding the more thoroughly studied issues of psychiatric disorders, adherence, and behavioral correlates of success in heart failure and transplantation may identify feasible strategies for optimizing care of LVAD patients and suggest directions for future research. Depression and distress complicate post-transplant care. Psychiatric morbidity is associated with poor outcomes, including graft rejection, non-adherence, hospitalizations, infection, and death. With a high risk of embolic neurological events, patients' ability for self-care may be compromised. Psychiatric symptoms are underdiagnosed and undertreated, which may impact overall survival and quality of life.

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Posttraumatic stress disorder after implantation of a Mechanical Assist Device Followed by Heart Transplantation: Evaluation of Patients and Partners

Cited by 59 publications

References 26 publications

Patient-Reported Outcomes in Left Ventricular Assist Device Therapy

Patient-Reported Outcomes in Left Ventricular Assist Device Therapy

The New Normal: A Bourdieusian Examination of Living Into Young Adulthood Being a Paediatric Heart Transplant Recipient

LVAD destination therapy: applying what we know about psychiatric evaluation and management from cardiac failure and transplant

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