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Health and Quality of Life Outcomes

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Open Access 01-12-2013 | Research

Overall mental distress and health-related quality of life after solid-organ transplantation: results from a retrospective follow-up study

Authors: Andreas Baranyi, Till Krauseneck, Hans-Bernd Rothenhäusler

Published in: Health and Quality of Life Outcomes | Issue 1/2013

Abstract

Background

Our retrospective follow-up study aimed to explore the degree of overall mental distress in a cohort of solid-organ transplantation (SOT) recipients after liver, heart or lung transplantation. Furthermore, we investigated how overall mental distress is linked to health-related quality of life.

Methods

123 SOT patients treated during the study period were enrolled in this investigation at a mean of 24.6 months (SD=11.6) after transplantation. Before transplantation, the Transplant Evaluation Rating Scale (TERS) was used to classify the level of adjustment in psychosocial functioning among transplantation candidates. After transplantation, recipients completed a research battery, which included the SCL-90-R, and the SF-36.

Results

39 (31.7%) transplantation recipients had clinically significant overall mental distress as measured on the Global Severity Index of the SCL-90-R. Obsessive-compulsive symptoms (92.3%), somatization symptoms (87.2%), anxiety symptoms (84.6%), depression symptoms (82.1%) and phobic anxiety symptoms (69.2%) were a frequent finding.

Transplantation recipients with overall mental distress had significant lower levels of adjustment in psychosocial functioning before transaplantation than those without overall mental distress as measured in the TERS. Transplantation-related overall mental distress symptomatology was associated with maximal decrements in health-related quality of life.

Conclusion

Transplantation recipients may face major transplantation- and treatment-related overall mental distress and impairments to their health-related quality of life. Further, overall mental distress is a high-risk factor in intensifying impairments to patients’ overall quality of life.

Freeman AM 3rd, Westphal JR, Davis LL, Libb JW: The future of organ transplant psychiatry. Psychosomatics 1995,36(5):429–437. 10.1016/S0033-3182(95)71623-1PubMedCrossRef

Collis I, Burroughs A, Rolles K, Lloyd G: Psychiatric and social outcome of liver transplantation. Br J Psychiatry 1995,166(4):521–524. 10.1192/bjp.166.4.521PubMedCrossRef

Commander M, Neuberger J, Dean C: Psychiatric and social consequences of liver transplantation. Transplantation 1992,53(5):1038–1040. 10.1097/00007890-199205000-00013PubMedCrossRef

Fukunishi I, Sugawara Y, Takayama T, Makuuchi M, Kawarasaki H, Kita Y, Aikawa A, Hasegawa A: Psychiatric problems in living-related transplantation (I): incidence rate of psychiatric disorders in living-related transplantation. Transplant Proc 2002,34(7):2630–2631. 10.1016/S0041-1345(02)03454-1PubMedCrossRef

Baranyi A, Rösler D, Rothenhäusler HB: Stress symptoms and health-related quality of life in patients after orthotopic liver transplantation. Z Psychosom Med Psychother 2012,58(4):417–428.PubMed

Kizilisik AT, Shokouh-Amiri MH, Tombazzi CR, Desmukh S, Grewal HP, Vera SR, Gaber AO: Psychiatric complications after liver transplantation. Transplant Proc 2001,33(7–8):3697.PubMedCrossRef

Olbrisch ME, Benedict SM, Ashe K, Levenson JL: Psychological assessment and care of organ transplant patients. J Consult Clin Psychol 2002,70(3):771–783.PubMedCrossRef

Potts SG: Transplant psychiatry. J R Coll Physicians Edinb 2009,39(4):331–336. 10.4997/JRCPE.2009.410PubMedCrossRef

Rothenhausler HB, Ehrentraut S, Kapfhammer HP: Psychosocial screening and selection of candidates for liver transplantation. Psychother Psychosom Med Psychol 2003,53(9–10):364–375.PubMed

10.

Rothenhausler HB, Ehrentraut S, Kapfhammer HP, Lang C, Zachoval R, Bilzer M, Schelling G, Gerbes AL: Psychiatric and psychosocial outcome of orthotopic liver transplantation. Psychother Psychosom 2002,71(5):285–297. 10.1159/000064811PubMedCrossRef

11.

Sears SF Jr, Marhefka SL, Rodrigue JR, Campbell C: The role of patients’ ability to pay, gender, and smoking history on public attitudes toward cardiac transplant allocation: an experimental investigation. Health Psychol 2000,19(2):192–196.PubMedCrossRef

12.

Duffy JP, Kao K, Ko CY, Farmer DG, McDiarmid SV, Hong JC, Venick RS, Feist S, Goldstein L, Saab S, Hiatt JR, Busuttil RW: Long-term patient outcome and quality of life after liver transplantation: analysis of 20-year survivors. Ann Surg 2010,252(4):652–661.PubMed

13.

Saeed I, Rogers C, Murday A, Steering Group of the UK Cardiothoracic Transplant Audit: Health-related quality of life after cardiac transplantation: results of a UK National Survey with Norm-based Comparisons. J Heart Lung Transplant 2008,27(6):675–681. 10.1016/j.healun.2008.03.013PubMedCrossRef

14.

Santana MJ, Feeny D, Ghosh S, Nador RG, Weinkauf J, Jackson K, Schafenacker M, Zuk D, Hubert G, Lien D: The construct validity of the health utilities index mark 3 in assessing health status in lung transplantation. Health Qual Life Outcomes 2010, 8: 110. 10.1186/1477-7525-8-110PubMedCentralPubMedCrossRef

15.

Nicholas DB, Otley AR, Taylor R, Dhawan A, Gilmour S, Ng VL: Experiences and barriers to Health-Related Quality of Life following liver transplantation: a qualitative analysis of the perspectives of pediatric patients and their parents. Health Qual Life Outcomes 2010, 8: 150. 10.1186/1477-7525-8-150PubMedCentralPubMedCrossRef

16.

Fiebiger W, Mitterbauer C, Oberbauer R: Health-related quality of life outcomes after kidney transplantation. Health Qual Life Outcomes 2004, 2: 2. 10.1186/1477-7525-2-2PubMedCentralPubMedCrossRef

17.

Bevans MF, Mitchell SA, Barrett AJ, Bishop M, Childs R, Fowler D, Krumlauf M, Prince P, Shelburne N, Wehrlen L: Function, adjustment, quality of life and symptoms (FAQS) in allogeneic hematopoietic stem cell transplantation (HSCT) survivors: a study protocol. Health Qual Life Outcomes 2011, 9: 24. 10.1186/1477-7525-9-24PubMedCentralPubMedCrossRef

18.

Doctor JN, Zoellner LA, Feeny NC: Predictors of health-related quality-of-life utilities among persons with posttraumatic stress disorder. Psychiatr Serv 2011,62(3):272–277. 10.1176/appi.ps.62.3.272PubMedCentralPubMedCrossRef

19.

Schelling G, Richter M, Roozendaal B, Rothenhausler HB, Krauseneck T, Stoll C, Nollert G, Schmidt M, Kapfhammer HP: Exposure to high stress in the intensive care unit may have negative effects on health-related quality-of-life outcomes after cardiac surgery. Crit Care Med 2003,31(7):1971–1980. 10.1097/01.CCM.0000069512.10544.40PubMedCrossRef

20.

Schelling G, Stoll C, Kapfhammer HP, Rothenhausler HB, Krauseneck T, Durst K, Haller M, Briegel J: The effect of stress doses of hydrocortisone during septic shock on posttraumatic stress disorder and health-related quality of life in survivors. Crit Care Med 1999,27(12):2678–2683. 10.1097/00003246-199912000-00012PubMedCrossRef

21.

Twillman RK, Manetto C, Wellisch DK, Wolcott DL: The transplant evaluation rating scale. A revision of the psychosocial levels system for evaluating organ transplant candidates. Psychosomatics 1993,34(2):144–153. 10.1016/S0033-3182(93)71905-2PubMedCrossRef

22.

Derogatis LR, CPA: Confirmation of the dimensional structure of the SCL-90: a study in construct validation. J Clin Psychol 1977, 33: 981–989. 10.1002/1097-4679(197710)33:4<981::AID-JCLP2270330412>3.0.CO;2-0CrossRef

23.

Derogatis LR, Lipman RS, Covi L: SCL-90: an outpatient psychiatric rating scale–preliminary report. Psychopharmacol Bull 1973,9(1):13–28.PubMed

24.

Stewart AL, Hays RD, Ware JE Jr: The MOS short-form general health survey. Reliability and validity in a patient population. Med Care 1988,26(7):724–735. 10.1097/00005650-198807000-00007PubMedCrossRef

25.

Telles-Correia D, Barbosa A, Mega I, Barroso E, Monteiro E: Psychiatric and psychosocial predictors of medical outcome after liver transplantation: a prospective, single-center study. Transplant Proc 2011,43(1):155–157. 10.1016/j.transproceed.2010.12.006PubMedCrossRef

26.

Noma S, Hayashi A, Uehara M, Uemoto S, Murai T: Comparison between psychosocial long-term outcomes of recipients and donors after adult-to-adult living donor liver transplantation. Clin Transplant 2011,25(5):714–720. 10.1111/j.1399-0012.2010.01337.xPubMedCrossRef

27.

Kugler C, Geyer S, Gottlieb J, Simon A, Haverich A, Dracup K: Symptom experience after solid organ transplantation. J Psychosom Res 2009,66(2):101–110. 10.1016/j.jpsychores.2008.07.017PubMedCrossRef

28.

Kollner V, Schade I, Maulhardt T, Maercker A, Joraschky P, Gulielmos V: Posttraumatic stress disorder and quality of life after heart or lung transplantation. Transplant Proc 2002,34(6):2192–2193. 10.1016/S0041-1345(02)03198-6PubMedCrossRef

29.

Favaro A, Gerosa G, Caforio AL, Volpe B, Rupolo G, Zarneri D, Boscolo S, Pavan C, Tenconi E, D’Agostino C, Moz M, Torregrossa G, Feltrin G, Gambino A, Santonastaso P: Posttraumatic stress disorder and depression in heart transplantation recipients: the relationship with outcome and adherence to medical treatment. Gen Hosp Psychiatry 2011,33(1):1–7. 10.1016/j.genhosppsych.2010.10.001PubMedCrossRef

30.

Corruble E, Barry C, Varescon I, Falissard B, Castaing D, Samuel D: Depressive symptoms predict long-term mortality after liver transplantation. J Psychosom Res 2011,71(1):32–37. 10.1016/j.jpsychores.2010.12.008PubMedCrossRef

31.

Fusar-Poli P, Matteo L, de Luca M, Politi P, Cortesi M, Carboni V: Anxiety and depression after lung transplantation: mirtazapine as a first-choice agent? J Psychosom Res 2007,62(1):101. 10.1016/j.jpsychores.2006.10.019PubMedCrossRef

32.

Dew MA, Kormos RL, Winowich S, Harris RC, Stanford EA, Carozza L, Griffith BP: Quality of life outcomes after heart transplantation in individuals bridged to transplant with ventricular assist devices. J Heart Lung Transplant 2001,20(11):1199–1212. 10.1016/S1053-2498(01)00333-3PubMedCrossRef

33.

Goetzmann L, Klaghofer R, Wagner-Huber R, Halter J, Boehler A, Muellhaupt B, Schanz U, Buddeberg C: Psychosocial vulnerability predicts psychosocial outcome after an organ transplant: results of a prospective study with lung, liver, and bone-marrow patients. J Psychosom Res 2007,62(1):93–100. 10.1016/j.jpsychores.2006.07.023PubMedCrossRef

34.

Bownik H, Saab S: Health-related quality of life after liver transplantation for adult recipients. Liver Transpl 2009,15(Suppl 2):S42-S49.PubMedCrossRef

35.

Strauss B, Thormann T, Strenge H, Biernath E, Foerst U, Stauch C, Torp U, Bernhard A, Speidel H: Psychosocial, neuropsychological and neurological status in a sample of heart transplant recipients. Qual Life Res 1992,1(2):119–128. 10.1007/BF00439719PubMedCrossRef

Title: Overall mental distress and health-related quality of life after solid-organ transplantation: results from a retrospective follow-up study
Authors: Andreas Baranyi
Till Krauseneck
Hans-Bernd Rothenhäusler
Publication date: 01-12-2013
Publisher: BioMed Central
Published in: Health and Quality of Life Outcomes / Issue 1/2013
Electronic ISSN: 1477-7525
DOI: https://doi.org/10.1186/1477-7525-11-15

At a glance: The STEP trials

Springer Medicine

Overall mental distress and health-related quality of life after solid-organ transplantation: results from a retrospective follow-up study

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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