In a study of 527 renal transplant recipients who had a median follow-up of seven years, researchers Dorien M. Zelle, MD, and colleagues at the University Medical Center Groningen in Groningen, the Netherlands, demonstrated that subjects who experienced depression following transplantation had an increased risk of death.

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Using scores on the Symptom Checklist (SCL-90), the researchers classified subjects according to magnitude of depression—low, moderate, and high. The risk increased with the magnitude of depression. During a median follow-up of seven years, death occurred in 15%, 21%, and 31% of the low, moderate, and high depression groups, respectively. High depression was associated with a twofold increased risk for death after adjusting for confounders. Risk factors for depressive symptoms included being unfit to work, living alone, dialysis duration, and low physical activity. The researchers observed no association with graft failure.