Depression and pain in heart transplant recipients: An observational study
Conway, Aaron, Sheridan, Judith, Maddicks-Law, Joanne, Fulbrook, Paul, Ski, Chantal, Thompson, David R., Clark, Robyn, & Doering, Lynn (2016) Depression and pain in heart transplant recipients: An observational study. Biological Research For Nursing. (In Press)
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- Characterising how physical and psychological symptoms interact in heart transplant recipients may lead to advances in therapeutic options. The aim of this study was to examine associations between pain and major depression.
- A cross-sectional study was conducted with adult heart transplant recipients. Pain was measured with the bodily pain domain of the Medical Outcomes Short Form-36 item health survey, psychological distress was measured with the Kessler Psychological Distress 10-item Scale (K-10) and a structured psychological interview (Mini International Neuropsychiatric Interview Version 6) was used to identify who met the criteria for major depression. Hierarchical linear regression was used to determine if there was an association between pain and major depression, controlling for pharmacological treatment of depression, severity of psychological distress and clinical characteristics including immunosuppression medication.
- Average pain score of the 48 heart transplant recipients was 43 (SD±10; range 0-100; lower scores indicate worse pain), moderate pain was reported by 39% (n=19). Major depression was associated with worse pain (R2 change=36%; β=-16; 95% CI=-30 to -4; p=.012). Pharmacological treatment for depression was associated with better pain scores (R2 change=1.5%; β=13; 95% CI=4 to 23; p=.006).
- We identified that heart transplant recipients with major depression had worse pain after controlling for pharmacological treatment of depression, severity of psychological distress and clinical characteristics including the medications used for immunosuppression, which are known to induce pain as a side effect. Thus, it is imperative that clinicians devising a treatment regimen for pain in heart transplant recipients take in to account co-occurring depression, and vice versa.
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