OBJECTIVE: This study prospectively investigated the relation between
pretransplant assessment of psychiatric diagnosis, coping skills, and
social support and outcome measures of survival and health care
utilization. METHOD: Ninety-four heart transplant patients underwent
structured interviews and completed a battery of self-report psychometric
tests assessing coping style, health status, and psychosocial supports.
Follow-up that ranged from 9 to 56 months after transplant produced a group
of 63 survivors and 31 nonsurvivors, who were found to be comparable in
terms of pretransplant cardiac status and severity of illness. RESULTS:
Survival analysis showed that dimensional psychometric measures of coping
and social support based on patient self-assessment were the best
significant predictors of survival. Considered separately,
interview-determined ratings of social support and pretransplant compliance
with treatment regimens were also potential predictors. Formal DSM-III-R
diagnoses were related specifically to posttransplant hospital utilization
(axis I diagnoses) and posttransplant health behavior (axis II diagnoses).
CONCLUSIONS: The data demonstrate the value of multifaceted assessment,
since psychiatric diagnosis, coping style, and psychosocial support may
contribute differently to prediction of such aspects of outcome as
mortality and health care utilization.