Psychological and cognitive status before and after heart transplantation

Deshields, Teresa L.; McDonough, Erin; Mannen, R.Kelley; Miller, Leslie W.

doi:10.1016/s0163-8343(96)00078-3

Cited by 87 publications

(59 citation statements)

References 17 publications

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“…Reversibility of cognitive impairment after medical treatment or heart transplantation has been suggested by some authors [37,38] . In view of our findings, it could be suggested that this is more likely to occur in the early stages of heart disease before the brain has suffered structural damage.…”

Section: Discussionmentioning

confidence: 99%

Neuroimaging and Correlates of Cognitive Function among Patients with Heart Failure

Vogels

Oosterman²,

Harten

et al. 2007

Dement Geriatr Cogn Disord

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Background/Aims: We purposed to investigate the relationship between cerebral abnormalities detected by magnetic resonance imaging (MRI) and cognitive performance in nondemented outpatients with heart failure (HF). Methods: In 58 patients with HF neuropsychological assessment was performed including tests of mental speed, executive functions, memory, language and visuospatial functions. Deep, periventricular and total white matter hyperintensities (WMH), lacunar and cortical infarcts, global and medial temporal lobe atrophy (MTA) were investigated on MRI of the brain. Correlations between MRI findings and the cognitive measures were calculated. Results: MTA correlated with memory (r = –0.353, p < 0.01), with executive functions (r = –0.383, p < 0.01) and the Mini Mental State Examination (r = –0.343, p < 0.05). Total WMH and deep WMH were found to correlate with depression and anxiety scores, but not with cognitive measures. Age, estimated premorbid intelligence and MTA were independent predictors of diminished cognitive performance. Conclusions: In HF patients, MTA was related to cognitive dysfunction, involving memory impairment and executive dysfunction, whereas WMH was related to depression and anxiety.

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Section: Discussionmentioning

confidence: 99%

Neuroimaging and Correlates of Cognitive Function among Patients with Heart Failure

Vogels

Oosterman²,

Harten

et al. 2007

Dement Geriatr Cogn Disord

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“…They suggest a need to turn attention to psychosocial problems, not as predictors of graft life, compliance, or posttransplant complications, but as important in themselves. Such an effort would clarify the transplant patients' psychosocial experience, and create an understanding of patient problems calling for intervention (Deshields et al, 1996). These authors also believe that patients are more likely to reveal serious psychosocial problems where there is a perception that the transplant team exhibits a real interest.…”

Section: Are Psychosocial Problems Underreported?mentioning

confidence: 99%

“…Mai and colleagues (1990) on the other hand, found that a pretransplant psychological diagnosis was highly correlated with posttransplant compliance to the medical regimen. Deshields, McDonough, Mannen, and Miller (1996) express concern about using pretransplant psychological diagnoses to predict those who will be noncompliant. While acknowledging that some studies show a relationship between psychological symptoms and compliance, they make the point that the pretransplant experience is extremely stressful and patients will likely manifest psychological symptoms during that time.…”

Section: Medication and Medical Regimen Compliancementioning

confidence: 99%

Psychosocial aspects of the organ transplant experience: What has been established and what we need for the future

Engle¹

2001

J Clin Psychol

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This article briefly describes the current status and limitations of the organ transplant process that has now become a routine medical procedure. The article discusses how transplantation is not a cure for end-stage organ disease but an alternative form of treatment with both potential medical and psychosocial problems. Both transplant candidates and recipients encounter psychosocial problems. The article examines how these psychosocial problems affect transplant patients prior to transplant, immediately following surgery, and posttransplant. The psychosocial problems include psychiatric diagnoses, individual and family adjustment and relationship problems, sexual dysfunction, return-to-work (RTW) difficulties, and compliance problems and variables related to noncompliance. The article also reviews the special problems of pediatric and adolescent transplant recipients. The need for empirically supported interventions is noted in each of the problem areas. The author outlines problems with previous research studies that hamper solid interpretations of the data, and discusses literature suggesting that the psychosocial problems of transplant candidates and recipients are likely to be underreported. The article concludes with recommendations about the need to switch research efforts toward intervention studies in the problem areas already solidly identified by the literature.

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“…Post-transplant depression has been linked to reduced compliance with various aspects of the medical regimen pre-and post-transplant [13]. Depression has been associated with increased hospital utilization costs [14], the number of rejection episodes after heart transplantation [15], and higher mortality and morbidity rates [13]. The pathway or process by which depression affects these outcomes is not fully understood; however, noncompliance is likely to play an important role in this association.…”

Section: Introductionmentioning

confidence: 99%