Previous reports have found elevated rates of psychopathology in recipients of implantable cardioverter defibrillators (ICDs). Thirty-five consecutive ICD recipients were assessed by using the Structured Clinical Interview for DSM-III-R and a semistructured questionnaire; assessments were performed within 3 days of ICD implantation (Time 1) and again 9-18 months later (Time 2). At the initial assessment, alcohol dependence in remission was the most common diagnosis, followed by mood disorders. Two cases of depression were found at follow-up assessment, but those subjects had either a lifetime history of major depression or some depressive symptoms at Time 1. No new cases of anxiety disorders were seen at Time 2. It appears that ICD recipients have rates similar to the general population at the time of implantation, and the risk for new psychopathology is largely confined to those with a lifetime history of psychopathology.