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Sobregrau P, Peri JM, Sánchez del Valle R, Molinuevo JL, Barra B, Pintor L. Psychiatric and Psychosocial Characteristics of a Cohort of Spanish Individuals Attending Genetic Counseling Due to Risk for Genetically Conditioned Dementia. J Alzheimers Dis Rep 2022; 6:461-478. [PMID: 36186729 PMCID: PMC9484134 DOI: 10.3233/adr-210067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 07/13/2022] [Indexed: 11/15/2022] Open
Abstract
Background: Predictive genetic tests are presently effective over several medical conditions, increasing the demand among patients and healthy individuals. Considering the psychological burden suspected familial dementia may carry on individuals, assessing personality, coping strategies, and mental health could aid clinicians in findings the appropriate time for delivering genetic test results and predict compliance regarding genetic counseling and expectations towards the genetic condition depending on the outcome. Objective: To describe the psychiatric, psychological, and coping characteristics of a sample of Spanish individuals at risk of familial dementia before genetic test results were given. Methods: We included 54 first degree relatives of patients diagnosed with Alzheimer’s disease, lobar frontotemporal degeneration, or prion diseases. The NEO-FFI-R, COPE, and HADS tests evaluated personality, coping strategies, and psychological distress, respectively. Results: Anxiety and depression were below the cut-off point for mild severity. Conscientiousness and Agreeableness were the most preponderant personality factors, while Neuroticism was the least. Positive reinterpretation and Acceptance were the most frequent coping strategies, and Denial and Alcohol and drug use were the least used. Ongoing medical pathologies increased depression, while psychiatric disorders worsened psychological distress. Conclusion: Contrary to our expectations, PICOGEN candidates showed psychological distress and personality traits within normative ranges, and the use of problem-focused coping strategies prevailed over avoidance coping strategies. Nevertheless, clinicians should pay particular attention to individuals attending genetic counseling who are women, aged, and present an ongoing psychiatric disorder and psychiatric history at inclusion to ensure their mental health and adherence throughout the process.
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Affiliation(s)
- Pau Sobregrau
- Psychiatry Department, Clinical Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain
- Psychology Faculty, University of Barcelona (UB), Barcelona, Spain
| | - Josep M. Peri
- Psychiatry Department, Clinical Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Raquel Sánchez del Valle
- Neurology Department, Clinical Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain
- Biomedical Research Institute August Pi i Sunyer (IDIBAPS), Hospital Clinic of Barcelona, Barcelona, Spain
| | | | - Bernardo Barra
- Clínica Universidad de Los Andes, Servicio de Salud Mental, Santiago, Chile
- Psychiatric Department, School of Medicine, Andrés Bello University, Santiago, Chile
| | - Luís Pintor
- Psychiatry Department, Clinical Institute of Neurosciences, Hospital Clinic of Barcelona, Barcelona, Spain
- Psychology Faculty, University of Barcelona (UB), Barcelona, Spain
- Biomedical Research Institute August Pi i Sunyer (IDIBAPS), Hospital Clinic of Barcelona, Barcelona, Spain
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Taghavi S, Afshar PF, Bagheri T, Naderi N, Amin A, Khalili Y. The Relationship Between Spiritual Health and Quality of Life of Heart Transplant Candidates. JOURNAL OF RELIGION AND HEALTH 2020; 59:1652-1665. [PMID: 31745694 DOI: 10.1007/s10943-019-00950-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The heart transplantation is a stressful event, and its waiting time is often associated with worsening of clinical conditions and deterioration of the patient's quality of life. Spirituality plays an important role in mental health, so the present study was conducted to investigate the relationship between spiritual health and quality of life of patients undergoing cardiac transplantation. The present descriptive study was performed on 48 patients undergoing cardiac transplantation at the Shahid Rajaee Cardiovascular Center in Tehran during the first half of 2016. The data were collected by Ellisan-Palutzian Spiritual Well-Being Scale, Minnesota Living with Heart Failure Questionnaire (MLHFQ) and Iranian Heart Failure Quality of Life Questionnaire (IHF-QOL). We used the SPSS v.20 software to analyze the data via descriptive statistics, parametric and non-parametric correlation and regression tests. The majority of patients (60.4%) had high spiritual health with a median score of 105, and its religious dimension was reported better (P < 0.001 and r = 0.591). With a mean of 63.23 ± 23.25, the quality of life of the majority of patients (75%) was at a poor level based on the Minnesota questionnaire. According to the IHF-QOL, the median total score was 39.50. There was a significant relationship between spiritual health score and quality of life in both questionnaires (MLHFQ: P = 0.006 and r = - 394; IHF-QOL: P = 0.022 and r = 0.329). Considering the positive relationship between spiritual health and quality of life of patients in this study, it is recommended to implement spiritual care and provide fulfillment for various needs of patients along with other medical care services.
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Affiliation(s)
- Sepideh Taghavi
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Pouya Farokhnezhad Afshar
- School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Tooran Bagheri
- Burn Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Nasim Naderi
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Amin
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Yasaman Khalili
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
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Cagliostro MATTHEW, BROMLEY ANDREW, TING PETER, DONEHEY JOHN, FERKET BART, PARKS KIRA, PALUMBO ELYSE, MANCINI DONNA, ANYANWU ANELECHI, PAWALE AMIT, PINNEY SEAN, MOSS NOAH, LALA ANURADHA. Standardized Use of the Stanford Integrated Psychosocial Assessment for Transplantation in LVAD Patients. J Card Fail 2019; 25:735-743. [DOI: 10.1016/j.cardfail.2019.06.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 05/30/2019] [Accepted: 06/14/2019] [Indexed: 10/26/2022]
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Association between the Big Five factors of personality and survival seven years after heart transplantation. Gen Hosp Psychiatry 2019; 58:24-26. [PMID: 30825857 DOI: 10.1016/j.genhosppsych.2019.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 02/17/2019] [Accepted: 02/20/2019] [Indexed: 11/22/2022]
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Michaud L, Ludwig G, Berney S, Rodrigues S, Niquille A, Santschi V, Favre AS, Lange AC, Michels AA, Vrijens B, Bugnon O, Pilon N, Pascual M, Venetz JP, Stiefel F, Schneider MP. Immunosuppressive therapy after solid-organ transplantation: does the INTERMED identify patients at risk of poor adherence? Pharm Pract (Granada) 2016; 14:822. [PMID: 28042353 PMCID: PMC5184375 DOI: 10.18549/pharmpract.2016.04.822] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 10/26/2016] [Indexed: 12/23/2022] Open
Abstract
Background: Lack of adherence to medication is a trigger of graft rejection in solid-organ transplant (SOT) recipients. Objective: This exploratory study aimed to assess whether a biopsychosocial evaluation using the INTERMED instrument before transplantation could identify SOT recipients at risk of suboptimal post-transplantation adherence to immunosuppressant drugs. We hypothesized that complex patients (INTERMED>20) might have lower medication adherence than noncomplex patients (INTERMED≤20). Methods: Each patient eligible for transplantation at the University Hospital of Lausanne, Switzerland, has to undergo a pre-transplantation psychiatric evaluation. In this context the patient was asked to participate in our study. The INTERMED was completed pre-transplantation, and adherence to immunosuppressive medication was monitored post-transplantation by electronic monitors for 12 months. The main outcome measure was the implementation and persistence to two calcineurin inhibitors, cyclosporine and tacrolimus, according to the dichotomized INTERMED score (>20 or ≤20). Results: Among the 50 SOT recipients who completed the INTERMED, 32 entered the study. The complex (N=11) and noncomplex patients (N=21) were similar in terms of age, sex and transplanted organ. Implementation was 94.2% in noncomplex patients versus 87.8% in complex patients (non-significant p-value). Five patients were lost to follow-up: one was non-persistent, and four refused electronic monitoring. Of the four patients who refused monitoring, two were complex and withdrew early, and two were noncomplex and withdrew later in the study. Conclusion: Patients identified as complex pre-transplant by the INTERMED tended to deviate from their immunosuppressant regimen, but the findings were not statistically significant. Larger studies are needed to evaluate this association further, as well as the appropriateness of using a nonspecific biopsychosocial instrument such as INTERMED in highly morbid patients who have complex social and psychological characteristics.
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Affiliation(s)
- Laurent Michaud
- Psychiatric Liaison Service, University Hospital of Lausanne (CHUV). Lausanne ( Switzerland ).
| | - Gundula Ludwig
- Psychiatric Liaison Service, University Hospital of Lausanne (CHUV). Lausanne ( Switzerland ).
| | - Sylvie Berney
- General Psychiatry Service, University Hospital of Lausanne (CHUV). Lausanne ( Switzerland ).
| | | | - Anne Niquille
- Community Pharmacy, Department of Ambulatory Care & Community Medicine, University of Lausanne . Lausanne ( Switzerland ).
| | - Valérie Santschi
- Professor, La Source School of Nursing Sciences, University of Applied Sciences Western Switzerland . Lausanne ( Switzerland ).
| | - Anne-Sophie Favre
- Community Pharmacy, Department of Ambulatory Care & Community Medicine, University of Lausanne . Lausanne ( Switzerland ).
| | | | - Annemieke A Michels
- Community Pharmacy, Department of Ambulatory Care & Community Medicine, University of Lausanne . Lausanne ( Switzerland ).
| | - Bernard Vrijens
- University of Liège , Belgium and Chief Science Officer, Westrock Healthcare. Visé ( Belgium ).
| | - Olivier Bugnon
- School of pharmaceutical sciences, University of Geneva, University of Lausanne , Switzerland and Community Pharmacy, Department of Ambulatory Care & Community Medicine, University of Lausanne. Lausanne ( Switzerland ).
| | - Nathalie Pilon
- Transplantation Centre, University Hospital of Lausanne (CHUV) . Lausanne ( Switzerland ).
| | - Manuel Pascual
- Transplantation Centre, University Hospital of Lausanne (CHUV) . Lausanne ( Switzerland ).
| | - Jean-Pierre Venetz
- Transplantation Centre, University Hospital of Lausanne (CHUV) . Lausanne ( Switzerland ).
| | - Friedrich Stiefel
- Psychiatric Liaison Service, University Hospital of Lausanne (CHUV). Lausanne ( Switzerland ).
| | - Marie-Paule Schneider
- Community Pharmacy, Department of Ambulatory Care & Community Medicine, University of Lausanne , Switzerland and Community Pharmacy, School of Pharmaceutical Sciences, University of Geneva, University of Lausanne . Lausanne ( Switzerland ).
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Sánchez R, Baillès E, Bastidas A, Serrano L, Pérez-Villa F, Castel MÁ, Pintor L. A New Quantitative Approach to Assessing Noncompliance With Medical Recommendations in Heart Transplant Recipients. Transplant Proc 2016; 48:2178-80. [PMID: 27569967 DOI: 10.1016/j.transproceed.2016.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 05/04/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Failure of compliance with medical regimen is one of the major risk factors associated with morbidity and mortality in heart transplant (HT) recipients. Nevertheless, to date, there is no specific, gold-standard, comprehensive set of tools for assessing compliance in these patients. OBJECTIVE The objective of the present study was to develop a specific instrument for the assessment of noncompliance with medical recommendations in HT recipients. METHODS This prospective observational study used a nonprobability sampling method, which was performed from January 2006 to December 2012. All of the patients met clinical criteria for being included on the waiting list for a HT. We designed a scale for measuring the compliance degree at 12 months after heart transplantation. This scale included the most important aspects of the medical regimen, using nine discrete quantitative variables. The total score was described as the patient's Noncompliance Factor (NCF). The results were analysed by mean, ranks, and percentages. RESULTS The sample was constituted of 61 participants who underwent surgical HT intervention and completed the 12-month follow-up assessment. The overall incidence of noncompliance was around 30% and only 43.1% of the recipients had an acceptable degree of compliance. CONCLUSIONS The overall incidence of noncompliance in HT recipients is high and this can generate worse clinical outcomes. Evaluation by specific screening instruments like the one proposed in the present study can be useful for a systematic detection of this phenomenon.
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Affiliation(s)
- R Sánchez
- Department of Psychiatry, Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, Barcelona, Spain.
| | - E Baillès
- Department of Psychiatry, Institut de Neurociències, Hospital Clínic i Provincial de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain
| | - A Bastidas
- Department of Psychiatry, Institut de Neurociències, Hospital Clínic i Provincial de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain
| | - L Serrano
- Department of Psychiatry, Institut de Neurociències, Hospital Clínic i Provincial de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain
| | - F Pérez-Villa
- Department of Cardiology, Heart Transplantation Division, Instituto Clínico del Tórax, Hospital Clínic i Provincial de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain
| | - M Á Castel
- Department of Cardiology, Heart Transplantation Division, Instituto Clínico del Tórax, Hospital Clínic i Provincial de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain
| | - L Pintor
- Department of Psychiatry, Institut de Neurociències, Hospital Clínic i Provincial de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain
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Sánchez R, Baillès E, Peri JM, Bastidas A, Pérez-Villa F, Bulbena A, Pintor L. Assessment of psychosocial factors and predictors of psychopathology in a sample of heart transplantation recipients: a prospective 12-month follow-up. Gen Hosp Psychiatry 2016; 38:59-64. [PMID: 26633863 DOI: 10.1016/j.genhosppsych.2015.10.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 09/02/2015] [Accepted: 10/03/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVES In the last decades, researchers of heart transplantation (HT) programs have attempted to identify the existence of psychosocial factors that might influence the clinical outcome before and after the transplantation. The first objective of this study is the prospective description of changes in psychiatric and psychosocial factors in a sample of HT recipients through a 12-month follow-up. The second goal is to identify predictors of psychopathology 1 year after HT. METHODS Pretransplant baseline assessment consisted of clinical form; Hospital Anxiety and Depression Scale (HADS); Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Structured Clinical Interview; Coping questionnaire (COPE); Five Factors Inventory Revised; Apgar-Family questionnaire and Multidimensional Health Locus of Control (MHLC). The assessment 1 year after HT consisted of HADS, COPE, Apgar-Family and MHLC. RESULTS The sample included 78 recipients. During the waiting list period, 32.1% of them had a psychiatric disorder; personality factors profile was similar to the general population, and they showed adaptive coping strategies. Some changes in psychosocial factors were observed at 12 months after the surgery: lower scores of anxiety and depression, less necessity of publicly venting of feelings and a trend to an internal locus of control. Neuroticism and Disengagement pre-HT were predictors of psychopathology in the follow-up assessment. CONCLUSIONS Pretransplant psychosocial screening is important and enables to find out markers of emotional distress like Neuroticism or Disengagement coping styles to identify patients who might benefit from psychiatric and psychological interventions. Successful HT involved some positive changes in psychosocial factors 12 months after the surgery beyond physical recovery.
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Affiliation(s)
- Roberto Sánchez
- Department of Psychiatry, Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain.
| | - Eva Baillès
- Department of Psychiatry, Institut de Neurociències, Hospital Clínic i Provincial de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Josep Maria Peri
- Department of Psychiatry, Institut de Neurociències, Hospital Clínic i Provincial de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Anna Bastidas
- Department of Psychiatry, Institut de Neurociències, Hospital Clínic i Provincial de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Félix Pérez-Villa
- Department of Cardiology, Heart Transplantation Division, Instituto Clínico del Tórax, Hospital Clínic i Provincial de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Antonio Bulbena
- Department of Psychiatry, Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
| | - Luis Pintor
- Department of Psychiatry, Institut de Neurociències, Hospital Clínic i Provincial de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
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Freudenreich O, Huffman JC, Sharpe M, Beach SR, Celano CM, Chwastiak LA, Cohen MA, Dickerman A, Fitz-Gerald MJ, Kontos N, Mittal L, Nejad SH, Niazi S, Novak M, Philbrick K, Rasimas JJ, Shim J, Simpson SA, Walker A, Walker J, Wichman CL, Zimbrean P, Söllner W, Stern TA. Updates in Psychosomatic Medicine: 2014. PSYCHOSOMATICS 2015; 56:445-59. [DOI: 10.1016/j.psym.2015.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 03/30/2015] [Accepted: 03/31/2015] [Indexed: 01/21/2023]
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Abstract
PURPOSE OF REVIEW Nonadherence is a major problem in heart transplantation (htx) and a challenge for clinical practice and research. In heart transplant recipients, nonadherence could cause chronic rejection of the transplanted heart followed by difficult clinical course and/or death of the patient. RECENT FINDINGS Main topics are the relationship between psychological aspects and adherence, risk factors and prediction of nonadherence, strategies for improving adherence like single-dose immunosuppressant therapy and follow-up studies. SUMMARY There is a lack of behavioral intervention studies. So-called targeted interventions should be defined for clinical practice and research with randomized controlled studies.
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