The Future of Organ Transplant Psychiatry

Freeman, Arthur M.; Westphal, J. A.; Davis, Lori L.; Libb, J. Wesley

doi:10.1016/s0033-3182(95)71623-1

Cited by 19 publications

(12 citation statements)

References 42 publications

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“…3 Malignancy includes hepatocellular carcinoma and other hepatic malignancies. 4 Miscellaneous comprises Wilson's disease, Budd-Chiari syndrome, fulminant hepatic failure, and cryptogenic cirrhosis. presents information on the treatment characteristics of the whole study sample and according to the diagnostic status of PTSD at the time of psychiatric assessment (see clinical status).…”

Section: Sociodemographic and Treatment Characteristicsmentioning

confidence: 99%

“…As transplantation surgery has dramatically advanced, the success of OLT is no longer judged solely by its effects on morbidity and mortality but by its influence on transplant recipients' psychosocial well-being [4]. In recent years, a number of outcome studies have focused on health-related quality of life (HRQOL) after liver transplantation among adults, showing that OLT is associated with improvement in HRQOL relative to the pretransplant period, but without restoring the health status levels described in the general population [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

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Psychiatric and Psychosocial Outcome of Orthotopic Liver Transplantation

Rothenhäusler¹,

Ehrentraut²,

Kapfhammer³

et al. 2002

Psychother Psychosom

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Background:The study aimed to explore the prevalence of psychiatric disorders among orthotopic liver transplantation (OLT) recipients, and to investigate how psychiatric morbidity was linked to health-related quality of life (HRQOL). Methods: We recruited 75 patients who had undergone OLT a median of 3.8 years previously (range = 5-129 months). Psychiatric morbidity was assessed using the Structural Clinical Interview for the DSM-III-R. Psychometric observer-rating and self-rating scales were administered to evaluate cognitive functioning (SKT), depressive symptomatology (HAMD 17 ), posttraumatic stress symptoms (PTSS-10), social support (SSS), and HRQOL (SF-36 Health Status Questionnaire). Treatment characteristics were obtained from medical records. Results: 22.7% (n = 17) of our sample had a current or probable psychiatric diagnosis according to DSM-III-R: 2.7% full posttraumatic stress disorder (PTSD) (n = 2), 2.7% major depressive disorder (MDD) comorbid to full PTSD (n = 2), 1.3% MDD comorbid to partial PTSD (n = 1), and 16% partial PTSD (n = 12). Patients with PTSD symptoms demonstrated lower cognitive performance, higher severity of depressive symptoms and more unfavorable perception of social support. OLT-related PTSD symptomatology was associated with maximal decrements in HRQOL. The duration of intensive care treatment, the number of medical complications, and the occurrence of acute rejection were positively correlated with the risk of PTSD symptoms subsequent to OLT. Conclusion: OLT-related PTSD symptomatology impairing HRQOL is a complication for a subgroup of OLT recipients. Health-care providers should be aware of the possible presence of PTSD in OLT survivors.

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Section: Sociodemographic and Treatment Characteristicsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Psychiatric and Psychosocial Outcome of Orthotopic Liver Transplantation

Rothenhäusler¹,

Ehrentraut²,

Kapfhammer³

et al. 2002

Psychother Psychosom

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“…For example, some studies found attempts to predict organ rejection based on psychological factors were largely unsuccessful (Canning, Dew, & Davidson, 1996;Steinberg, Levy, & Radvilla, 1981). Although the predictive value of these studies may be limited, knowledge of psychological states is important in informing professionals about the need to stabilize a patient psychologically before and after transplant (Freeman, Westphal, Davis, & Libb, 1995).…”

Section: Psychosocial Evaluationmentioning

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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“…4 Patients with ESLD have different psychologic, emotional, cognitive, physical, and social challenges before, during, and after transplant. [5][6][7][8][9][10] The chronic nature of the disease itself, 11 the wait and anticipation for an organ donor, 12 donor shortage, 13 the stressful pretransplant evaluation process, 14 transplant procedures, need for life modifications after transplant, 5 and the strict adherence to the treatment regimen, 15 as well as social isolation, 14 negatively affect the patient's quality of life. 14 It is not surprising that transplant candidates show high levels of anxiety 13 and depression, 16 which compels addressing the psychologic needs of candidates.…”

Section: Introductionmentioning

confidence: 99%

Psychologic Evaluation in Liver Transplantation: Assessment of Psychologic Profile of End-Stage Liver Disease Patients Before and After Transplant

Baghernezhad

Mani²,

Ayoobzadehshirazi³

et al. 2020

Exp Clin Transplant

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Objectives: Patients with end-stage liver disease face various psychologic challenges. We aimed to compare levels of depression, anxiety, fatigue, sleepiness, and memory in patients before and after liver transplant. Materials and Methods: Forty patients (24 male, 16 female) were recruited from the liver transplant clinic affiliated with Shiraz University of Medical Sciences. Patients between 18 and 60 years old with at least a 6th-grade level of education were included in the study; those with severe psychiatric problems were excluded. We performed the following assessments before and 1 month after liver transplant: Hospital Anxiety and Depression questionnaires, California Verbal Learning Test, Epworth Sleepiness Scale, and Fatigue Severity Scale. Paired-sample t tests were used. P < .05 was considered significant. Results: Level of depression in study patients increased after transplant (7.42 vs 8.42; P = .008). We found improvements in categories of immediate memory (65.23 vs 60; P = .007), short delay free recall (10.52 vs 12.52; P < .001), short delay cued recall (11.42 vs 13.00; P = .001), long delay free recall (10.80 vs 12.50; P = .003), long delay cued recall (11.80 vs 13.25; P = .003), and recognition (14.65 vs 15.42; P = .003).Patient levels of fatigue (39.9 vs 33.2; P = .029) and sleepiness (10.8 vs 7.8; P = .004) decreased. Level of anxiety did not change significantly (12.6 vs 12.8; P = .642). Conclusions:We observed higher levels of depression but improved fatigue, sleepiness, and memory function in patients after liver transplant. No significant change in patient level of anxiety was seen. Future direction is discussed.

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The Future of Organ Transplant Psychiatry

Cited by 19 publications

References 42 publications

Psychiatric and Psychosocial Outcome of Orthotopic Liver Transplantation

Psychiatric and Psychosocial Outcome of Orthotopic Liver Transplantation

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

Psychologic Evaluation in Liver Transplantation: Assessment of Psychologic Profile of End-Stage Liver Disease Patients Before and After Transplant

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