Brandwin M, Trask P C, Schwartz S M, Clifford M
Psychiatry Department, University of Michigan Health Systems, 475 Market Place, Suite L, Ann Arbor, MI 48108, USA.
J Psychosom Res. 2000 Aug;49(2):141-7. doi: 10.1016/s0022-3999(00)00152-5.
Emotional factors are generally recognized as impacting the care of end-stage heart disease and mortality following cardiac transplants. Equally important, however, are predictors of pretransplant mortality. The current study examined the utility of the Millon Behavioral Health Inventory (MBHI) as a predictor of pre- and posttransplant mortality.
A total of 103 cardiac transplant candidates were assessed with the MBHI as part of a pretransplant evaluation that included baseline demographic variables and cardiac status. Time to transplant and mortality status at 1 and 5 years was also obtained.
Cluster analysis of MBHI response scores elicited two clusters characterized by high and low distress. Cluster membership predicted survival status at 1-year and 5-year follow-up, with high distress cluster patients having significantly higher mortality in both the total sample and a subgroup of patients who did receive a heart transplant.
These results support the value of the MBHI for assessing personality attributes that may dispose toward unfavorable outcome in heart transplant candidates. Further understanding of psychosocial contributions to illness course and outcome may enable more effective selection of treatment interventions with cardiac patients.
情绪因素通常被认为会影响终末期心脏病的治疗以及心脏移植后的死亡率。然而，移植前死亡率的预测因素同样重要。本研究考察了米隆行为健康量表（MBHI）作为移植前和移植后死亡率预测指标的效用。
共有103名心脏移植候选者接受了MBHI评估，作为包括基线人口统计学变量和心脏状况在内的移植前评估的一部分。还获取了移植时间以及1年和5年时的死亡状况。
对MBHI反应分数进行聚类分析得出了两个以高痛苦和低痛苦为特征的聚类。聚类成员预测了1年和5年随访时的生存状况，在总样本以及接受了心脏移植的患者亚组中，高痛苦聚类患者的死亡率均显著更高。
这些结果支持了MBHI在评估可能导致心脏移植候选者出现不良结局的人格属性方面的价值。进一步了解心理社会因素对疾病进程和结局的影响，可能有助于更有效地为心脏病患者选择治疗干预措施。
