Depression, Anxiety, Resilience and Coping Pre and Post Kidney Transplantation – Initial Findings from the Psychiatric Impairments in Kidney Transplantation (PI-KT)-Study

Abstract

PurposeDepression/anxiety, impaired Health-Related Quality of Life (HRQoL) and coping and resilience structures, are associated with increased mortality/poor outcome in chronic kidney disease (CKD) patients before (CKD/pre-KT) and after kidney (CKD-T) transplantation. Less is known about prevalence rates of psychiatric symptoms and impaired HRQoL of non-transplanted compared with transplanted patients.MethodsIn a cross-sectional study comparing 101 CKD/pre-KT patients with 151 cadaveric-transplanted (CKD-T) patients, we examined prevalence of depression/anxiety (HADS questionnaire) and coping, resilience and HRQoL (SF-12, Resilience-Scale and FKV-questionnaire).ResultsThe prevalence of both depressive and anxiety symptoms was not significantly different between different pre-/and CKD-T patient groups. In CKD-T no significant relations of coping strategies with kidney function were identified. Furthermore, the Resilience Scales for acceptance and competence did not suggest any differences between the CKD/pre-KT and CKD-T subgroup. In the CKD/pre-KT patients, significant correlations were identified between the acceptance subscale and partnership, as well as between the competence subscale and older age/partnership.ConclusionsBoth the CKD/pre-KT and CKD-T patients exhibited notable impairments in the HRQoL which which showed a comparable pattern of results. KT itself does not appear to be the main risk factor for the development of mental impairments.

Relationship between quality of life, self-esteem and depression in people after kidney transplantation

“…The present study showed that the studied population did not present scores for the dysphoria classification. This result is in line with research in the area that evidenced in both pre and post-kidney transplant people a medium severity risk for depressive symptoms, given the application of the Hospital Anxiety and Depression Scale (HADS) scale, with lower prevalence of depressive symptoms in transplanted individuals (14) . These results, when compared to patients on hemodialysis, show a 22% proportion of patients with increased BDI indexes, suggesting a high rate of depression for patients on hemodialysis compared to kidney transplantation (34) .…”

“…Little is known about the prevalence of depression in kidney transplant recipients. However, when compared to the dialysis modality, kidney transplantation is associated with better clinical outcomes, better quality of life and lower rates of psychic morbidity (14) .…”

Psychological and Psychopathological Aspects of Kidney Transplantation: A Systematic Review

“…In the daily experience of transplanted patients, anxiety is a condition of alertness and apprehension that increases when infections occur, drug side effects and other conditions that expose the subject to a state of physical discomfort until the fear of rejection (44,52).…”

“…Muller et al (44) in a cross-sectional study studied the presence of anxiety and depression using the "Hospital anxiety and depression scale" (HADS-D/A) in kidney transplant patients. Regarding depression, the mean HADS-D scores were 4.48 ± 2.96; regarding anxiety the mean HADS-A scores were 5.01 ± 4.04.…”

Abnormal Illness Behavior, Alexithymia, Demoralization, and Other Clinically Relevant Psychosocial Syndromes in Kidney Transplant Recipients: A Comparative Study of the Diagnostic Criteria for Psychosomatic Research System versus ICD-10 Psychiatric Nosology

“…An average prevalence of 35% for psychiatric morbidity (e.g., major depression and anxiety disorders) has been reported in kidney transplant recipients (KTRs) [1, 2]. However, a higher prevalence of other psychosocial syndromes (e.g., demoralization, health anxiety, and irritable mood) not detectable by the usual psychiatric nosological systems has been found among medically ill patients using the Diagnostic Criteria for Psychosomatic Research (DCPR) [3].…”