Background: Although heart transplants have become more common, little is known about the psychological status of patients waiting for a heart transplant.
Methods: Thirty-eight inpatients waiting for heart transplantation from October 2010 to December 2011 in a large general hospital in Shanghai were assessed by a psychiatrist using the Hamilton Depression Scale and the Hamilton Anxiety Scale at admission and weekly thereafter until the operation took place.
Results: The patients included 30 males and 8 females with a mean (sd) age of 44.7 (12.9) years who had been seriously limited due to their heart disease (i.e., Stage III heart disease) for a mean of 18.5 (24.0) months. Among them, 7.9% (3/38) were moderately or severely depressed and 47.4 % (18/38) had moderate or severe anxiety symptoms; only one (2.6%) had concurrent moderate to severe anxiety and depression. There was a slight but statistically significant increase in both anxiety and depressive symptoms during the first week of hospitalization. In the stepwise backward logistic regression, the reported level of anxiety was significantly associated with the duration of Stage III heart disease (less anxiety in those with longer Stage III disease), prior treatment in an intensive care unit (associated with less anxiety), age (anxiety increases with age), and prior emergency cardiac treatment (associated with greater anxiety). Multivariate linear regression analysis also found that longer duration of Stage III disease and higher educational status were associated with reporting less depressive symptoms, but a longer total duration of heart disease was associated with reports of more depressive symptoms.
Conclusion: Unlike reports from other countries, we found that anxiety symptoms are more prevalent and more severe than depressive symptoms among inpatients waiting for heart transplantation in Shanghai. There is an inverse relationship between duration of disabling illness and the preoperative self-reports of anxiety and depressive symptoms: those who had had Stage III disease for over a year reported less severe anxiety and depressive symptoms than those who had had Stage III disease for less than a year.
背景: 心脏移植术逐渐增多，但对等待心脏移植患者的情绪状态却知之甚少。
方法: 2010年10月至2011年12月，由精神科医生对上海某大型综合性医院心外科住院等待心脏移植的38例患者进行汉密尔顿抑郁量表和汉密尔顿焦虑量表的评估，住院时评定一次，以后每周评估一次，直至手术。
结果: 共入组男性30例，女性8例，平均年龄44.7（12.9）岁，因为心脏疾病使活动严重受限（即心功能III级）的平均病程为18.5（24.0）个月。这些患者中存在中度和严重抑郁症状的比例为7.9%（3/38），中度和严重焦虑症状的比例为47.4%（18/38），同时存在中重度抑郁和焦虑症状的仅有1人（2.6%）。住院第一周焦虑症状和抑郁症状均轻度加重。逐步logistic回归分析（向后法）显示患者自我报告的焦虑水平与以下因素相关，心功能III级的病程越长，焦虑越轻；既往住重症监护病房者，焦虑程度轻；随年龄增大焦虑加重；既往存在因心脏疾病而接受急诊抢救史者焦虑更明显。多元线性回归分析还发现心功能III级的病程越长、受教育程度越高，患者报告的抑郁症状越少，但是心脏疾病的总病程越长，患者报告的抑郁症状越明显。
结论: 与国外的研究结果不同，我们发现在上海住院等待心脏移植者的焦虑症状比抑郁症状更为普遍、更为严重。疾病导致严重功能障碍的病程与术前自我报告的焦虑症状和抑郁症状的严重度负相关：心功能III级超过1年者报告的焦虑和抑郁症状要比不足1年者少。