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Sambucini D, Ciacchella C, Pellicano GR, Zingaretti G, Pierro L, Aceto P, Lai C. Psychosocial treatment on psychological symptoms, adherence, and physiological function on transplanted patients: A systematic review and metanalysis. J Psychosom Res 2022; 154:110717. [PMID: 35032913 DOI: 10.1016/j.jpsychores.2022.110717] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 12/31/2021] [Accepted: 01/03/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Transplantation represents an important source of hope for the candidates and produces an intense emotional effect. Psychosocial interventions can be helpful in all transplantation stages to better manage this extraordinarily stressful situation. Aim of the work is to verify the effects of the psychosocial interventions on recipients on psychological symptoms, medical adherence and transplanted solid organ functioning. METHODS This work adhered to PRISMA, STROBE, Cochrane and New Castle Ottawa bias scales and it is registered in PROSPERO. Inserting "Transplant" and "Psychological intervention" as key words in PubMed, Psycinfo, Cochrane database resulted 977 studies from 2001 to 2021. A systematic review and metanalyses were processed on nineteen randomized controlled trials and observative prospective cohort studies. The difference between pre- and post- psychosocial intervention assessment on the psychological variables, medical adherence, and organ functioning outcome was processed. RESULTS Main findings showed that the psychosocial interventions were effective on depression (0.62; CI: 0.32-0.92) and anxiety on kidney recipients (0.49; CI: 0.17-0.81), and on anxiety on heart recipients, mainly when administrated after the surgery (0.68; CI: 0.30-1.06). Moreover, the findings showed a lack of studies on the effectiveness of the psychosocial intervention on organ functioning. CONCLUSION The work highlighted the effectiveness of the psychosocial interventions on psychological outcome, particularly after the surgery and the need to address the research on the evaluation of the effectiveness of the psychosocial interventions on the organ functioning. The findings suggest to integrate the transplantation procedures with psychosocial interventions considering the different needs of recipients in relation to the specific transplanted organ.
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Affiliation(s)
- Daniela Sambucini
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University, Rome, Italy
| | - Chiara Ciacchella
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University, Rome, Italy
| | - Gaia Romana Pellicano
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University, Rome, Italy
| | - Giorgia Zingaretti
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University, Rome, Italy
| | - Laura Pierro
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University, Rome, Italy
| | - Paola Aceto
- Department of Emergency, anesthesiological and reanimation sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Department of Basic Biotechnological Sciences, Intensive Care and Perioperative Clinics, University of Sacred Heart, Rome, Italy
| | - Carlo Lai
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University, Rome, Italy.
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López-Navas AI, Ríos A, Flores-Medina J, Martínez-Alarcón L, Pons JA, Parrilla P, Ramírez P. Predisposition Toward Living Liver Donation Is Low Among Relatives of Patients on the Waiting List for Transplantation in Spain. Transplant Proc 2020; 52:476-479. [PMID: 32044078 DOI: 10.1016/j.transproceed.2019.12.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 12/20/2019] [Accepted: 12/26/2019] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The attitude toward living liver donation (LLD) among the Spanish population is mostly positive; however, the reality is that liver transplants from live donations are currently minimal. Given this situation, studies that analyze these discrepancies should be carried out. OBJECTIVE Analyze the attitude toward LLD among family members of patients on the waiting list for liver transplantation. METHOD Population under study. First-degree relatives of the patients included in the waiting list for liver transplantation. INCLUSION CRITERIA 1. Have the patient's authorization for family members to participate; 2. Accept, the relative, to participate in this investigation; and 3. Be over 18 years old. Opinion survey. The attitude toward LLD is assessed through a questionnaire on psychosocial aspects. RESULTS Patients who accepted family members' participation in the study were 21 of 112, of which 9 placed restrictions on family access, and 12 authorized family members without restrictions. The participants were 1. children: 52.2% (n = 24); 2. brothers: 30.5% (n = 14); and 3. partners: 17.3% (n = 14). Finally, the authorized relatives and participants in the study were 45. Of these, only 44% (n = 20) would accept to be donors. CONCLUSIONS The access to the LLD of the relatives starts from the restriction and initial rejection of the patients themselves on the waiting list. The promotion of LDD is to initially sensitize patients.
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Affiliation(s)
- Ana I López-Navas
- International Collaborative Donor Project ("Proyecto Colaborativo Internacional Donante"), Murcia, Spain; Department of Psychology, Catholic University of Murcia (UCAM), Murcia, Spain
| | - Antonio Ríos
- International Collaborative Donor Project ("Proyecto Colaborativo Internacional Donante"), Murcia, Spain; Department of Surgery, University of Murcia, Murcia, Spain; Transplant Unit, Surgery Service, IMIB - Virgen de la Arrixaca University Clinical Hospital, Murcia, Spain.
| | - Juan Flores-Medina
- Department of Psychology, Catholic University of Murcia (UCAM), Murcia, Spain
| | - Laura Martínez-Alarcón
- International Collaborative Donor Project ("Proyecto Colaborativo Internacional Donante"), Murcia, Spain; Department of Surgery, University of Murcia, Murcia, Spain; Transplant Unit, Surgery Service, IMIB - Virgen de la Arrixaca University Clinical Hospital, Murcia, Spain
| | - José Antonio Pons
- Digestive Service, University Hospital Virgen de la Arrixaca, Murcia Health Service, Murcia, Spain
| | - Pascual Parrilla
- International Collaborative Donor Project ("Proyecto Colaborativo Internacional Donante"), Murcia, Spain; Department of Surgery, University of Murcia, Murcia, Spain; Transplant Unit, Surgery Service, IMIB - Virgen de la Arrixaca University Clinical Hospital, Murcia, Spain
| | - Pablo Ramírez
- International Collaborative Donor Project ("Proyecto Colaborativo Internacional Donante"), Murcia, Spain; Department of Surgery, University of Murcia, Murcia, Spain; Transplant Unit, Surgery Service, IMIB - Virgen de la Arrixaca University Clinical Hospital, Murcia, Spain
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Stability of Psychiatric Diagnoses in Candidates to Liver Transplantation Referred to a Consultation-Liaison Psychiatry Service. J Clin Med 2019; 8:jcm8060800. [PMID: 31195696 PMCID: PMC6616975 DOI: 10.3390/jcm8060800] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 05/19/2019] [Accepted: 06/03/2019] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To investigate the stability over time of the psychiatric diagnoses among candidates to liver transplantation referred to a consultation-liaison psychiatric service. METHOD Descriptive study, carried out at the Consultation-Liaison Psychiatry Service (CLPS) placed at the Modena (Italy) General University Hospital. All patients waiting for liver transplantation and repeatedly referred to the CLPS were enrolled. The observation period was from 1 January 2008 to 31 December 2013. Pearson's coefficients were calculated to measure diagnostic stability (index referral vs. last referral). RESULTS One hundred patients were assessed (males 67%; mean age 53 ± 7 years old). The mean number of referrals for patients was 3 ± 2. The stability rate of psychiatric diagnosis was 64%. The following diagnoses or conditions were all significantly stable (i.e., all featured by r > 0.5 and p < 0.05): Adjustment disorder, depressive disorder, comorbid anxiety/depressive disorder, substance use disorder (including alcohol), absence of any disorder, and presence of any disorder. CONCLUSIONS The good level of diagnostic stability displayed in the sample may be a function of the clinical and organizational "style" of the CLPS, namely the focus on identifying the prevailing personality traits, defensive mechanisms, and relational patterns.
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Kahl KG, Eckermann G, Frieling H, Hillemacher T. Psychopharmacology in transplantation medicine. Prog Neuropsychopharmacol Biol Psychiatry 2019; 88:74-85. [PMID: 30018020 DOI: 10.1016/j.pnpbp.2018.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 06/07/2018] [Accepted: 07/05/2018] [Indexed: 12/18/2022]
Abstract
Organ transplantation has become a well-established treatment option in patients with end-stage organ diseases. Although quality of life has markedly improved, psychiatric disorders before and after transplantation are more frequent compared to the general population. Psychopharmacological treatment is recommended for almost all mental disorders according to current guidelines, but may pose particular problems in organ transplant patients. Changes in the metabolism and elimination of drugs during organ insufficiency, drug interactions, and overlapping side effects between psychopharmacological and immunosuppressive drugs are challenging problems in clinical management. Furthermore, questions frequently arise concerning the use of psychopharmacological treatment options for sleeping and anxiety disorders. This article reviews psychopharmacology in organ transplant patients, with particular attention to frequent psychiatric disorders observed in the disease course of end-stage organ diseases.
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Affiliation(s)
- Kai G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Medical School, Hannover, Germany; Section Polypharmacy, Working Group on Neuropsychopharmacology and Pharmacopsychiatry (AGNP), Germany.
| | - Gabriel Eckermann
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Medical School, Hannover, Germany; Section Polypharmacy, Working Group on Neuropsychopharmacology and Pharmacopsychiatry (AGNP), Germany
| | - Helge Frieling
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Medical School, Hannover, Germany
| | - Thomas Hillemacher
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Medical School, Hannover, Germany; Department of Psychiatry and Psychotherapy, Klinikum Nürnberg, Universitätsklinik der Paracelsus Medizinischen Privatuniversität, Germany
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Febrero B, Ramírez P, Martínez-Alarcón L, Abete C, Galera M, Ríos A, Robles-Martínez R, Ramírez-Pino PM, Almela J, Ramis G, Pons JA, Parrilla P. Group Psychotherapy Could Improve Depression in Cirrhotic Patients on the Liver Transplant Waiting List. Transplant Proc 2018; 51:28-32. [PMID: 30685106 DOI: 10.1016/j.transproceed.2018.02.206] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 01/28/2018] [Accepted: 02/02/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND It is well-known that there is a high incidence of depression in patients on the liver transplant (LT) waiting list. However, there have been few studies of psychological intervention on these patients. OBJECTIVES To determine symptoms of depression in patients on the LT waiting list and the impact of group psychotherapy. METHODS Study population: patients on the LT waiting list who received group psychotherapy (n = 15). CONTROL GROUP patients who did not receive psychotherapy (n = 10). Measurement instrument: Beck's depression test, which was provided before psychotherapy was initiated and after it was completed (after 6 months). The control group was given the questionnaire at the same 2 points in time as the study group. The psychotherapeutic method consisted of discussing patients' feelings, which dealt with several matters related to transplantation. Different coping strategies were considered. RESULTS More than half of those surveyed initially had depressive symptoms. When the second survey was administered to the study population, all the patients improved in their psychopathological assessment. When the survey was administered to the control group, a worse psychopathological assessment was obtained in all cases. CONCLUSIONS Our data suggest an improvement in depressive symptoms in patients on the LT waiting list after receiving group psychotherapy.
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Affiliation(s)
- B Febrero
- Transplant Unit, General Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain, Instituto Murciano de Investigaciones Biomédicas (IMIB); Department of Surgery, University of Murcia, Murcia, Spain.
| | - P Ramírez
- Transplant Unit, General Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain, Instituto Murciano de Investigaciones Biomédicas (IMIB); Department of Surgery, University of Murcia, Murcia, Spain; Regional Transplant Center, Consejería de Sanidad y Consumo de la Región de Murcia, Spain
| | - L Martínez-Alarcón
- Transplant Unit, General Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain, Instituto Murciano de Investigaciones Biomédicas (IMIB); Department of Surgery, University of Murcia, Murcia, Spain
| | - C Abete
- Transplant Unit, General Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain, Instituto Murciano de Investigaciones Biomédicas (IMIB)
| | - M Galera
- Transplant Unit, General Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain, Instituto Murciano de Investigaciones Biomédicas (IMIB)
| | - A Ríos
- Transplant Unit, General Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain, Instituto Murciano de Investigaciones Biomédicas (IMIB); Department of Surgery, University of Murcia, Murcia, Spain
| | - R Robles-Martínez
- Transplant Unit, General Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain, Instituto Murciano de Investigaciones Biomédicas (IMIB)
| | - P M Ramírez-Pino
- Transplant Unit, General Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain, Instituto Murciano de Investigaciones Biomédicas (IMIB)
| | - J Almela
- Department of Surgery, University of Murcia, Murcia, Spain
| | - G Ramis
- Department of Surgery, University of Murcia, Murcia, Spain
| | - J A Pons
- Transplant Unit, General Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain, Instituto Murciano de Investigaciones Biomédicas (IMIB)
| | - P Parrilla
- Transplant Unit, General Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain, Instituto Murciano de Investigaciones Biomédicas (IMIB); Department of Surgery, University of Murcia, Murcia, Spain
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Aguiar MIFD, Alves NP, Braga VAB, Souza ÂMAE, Araújo MÂM, Almeida PCD. ASPECTOS PSICOSSOCIAIS DA QUALIDADE DE VIDA DE RECEPTORES DE TRANSPLANTE HEPÁTICO. TEXTO & CONTEXTO ENFERMAGEM 2018. [DOI: 10.1590/0104-070720180003730016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivo: avaliar a dimensão psicossocial da qualidade de vida de pacientes antes e depois do transplante hepático. Método: estudo descritivo, transversal, com abordagem quantitativa, com 150 pacientes submetidos ao transplante de fígado em seguimento a partir do sexto mês, no ambulatório de um centro de referência em transplante hepático. A coleta de dados foi realizada a partir da aplicação de um instrumento com dados sociodemográficos/clínicos e do questionário Liver Disease Quality of Life. Foi utilizada análise estatística descritiva, teste t de Student para comparação das médias dos domínios e Games-Howell para comparações múltiplas. Resultados: houve melhoria nos níveis de qualidade de vida pós-transplante nos quatro domínios avaliados (<0,0001), com maior elevação de escores para os domínios: preocupação (55,5 vs 87,9) e estigma da doença hepática (58,6 vs 93,7). Conclusão: o estudo demonstrou que os pacientes submetidos ao transplante hepático obtiveram uma melhoria significativa da percepção da qualidade de vida no que diz respeito à dimensão psicossocial, sendo mais perceptiva nos domínios preocupação e estigma da doença hepática.
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7
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Oral health-related quality of life depending on dental and periodontal health in different patients before and after liver transplantation. Clin Oral Investig 2017; 22:2039-2045. [DOI: 10.1007/s00784-017-2298-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 12/06/2017] [Indexed: 12/12/2022]
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Mattei G, Laghi A, Balduzzi S, Moscara M, Piemonte C, Reggianini C, Rigatelli M, Ferrari S, Pingani L, Galeazzi GM. Indicators of Complex Care During the Consultation-Liaison Psychiatry Activity at the Transplant Center of the Policlinico Hospital, Modena. Transplant Proc 2017; 49:2105-2109. [PMID: 29149969 DOI: 10.1016/j.transproceed.2017.09.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 07/12/2017] [Accepted: 09/02/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The objective of this study was to identify possible biopsychosocial predictors of organizational complexity in patients referred to the consultant psychiatrist for assessment before liver transplantation. METHODS This was a case-control study. All psychiatric consultations performed before and after liver transplantation from January 1, 2008 to December 31, 2013 were included. Complexity was operationalized as "undergoing two or more psychiatric consultations". Controls were defined as patients who were assessed only once by the consultant. Cases were represented by patients who underwent two or more consultations. Statistical analysis was performed with STATA 13.1, using logistic regressions. RESULTS In this study, 515 consultations were requested for 309 patients potentially eligible for liver transplantation. Controls were 209 (67.6%); cases were 100 (32.4%). Positive psychiatric history (odds ratio [OR] = 2.44; 95% confidence interval [CI], 1.43-4.16), viral or toxic (alcohol- or drug-related) liver disease (OR = 1.93; 95% CI, 1.09-3.42), use of psychotropic medications at the baseline (OR = 2.15; 95% CI, 1.14-4.07), and female gender (OR = 1.77; 95% CI, 1.01-3.11) were significantly associated with an increased probability of being cases. CONCLUSIONS Positive psychiatric history, viral or toxic liver disease, use of psychotropic medications at the index referral, and female gender are possible biopsychosocial predictors of complexity in patients eligible for liver transplantation.
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Affiliation(s)
- G Mattei
- Department of Diagnostics, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy; Association for Research in Psychiatry, Castelnuovo Rangone, Italy
| | - A Laghi
- Department of Diagnostics, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - S Balduzzi
- Department of Diagnostics, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - M Moscara
- Department of Mental Health, Local Health Agency, Modena, Modena, Italy
| | - C Piemonte
- Department of Diagnostics, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - C Reggianini
- Department of Diagnostics, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - M Rigatelli
- Department of Diagnostics, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - S Ferrari
- Department of Diagnostics, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - L Pingani
- Human Resources, Department of Mental Health, Local Health Agency Reggio Emilia, Reggio Emilia, Italy
| | - G M Galeazzi
- Department of Diagnostics, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy.
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Liver Transplantation: Candidate Selection and Organ Allocation in the United States. Int Anesthesiol Clin 2017; 55:5-17. [PMID: 28288029 DOI: 10.1097/aia.0000000000000142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Ramírez P, Febrero B, Martínez-Alarcón L, Abete C, Galera M, Cascales P, López-Navas AI, González MR, Ríos A, Pons JA, Parrilla P. Benefits of Group Psychotherapy in Cirrhotic Patients on the Liver Transplant Waiting List. Transplant Proc 2016; 47:2382-4. [PMID: 26518934 DOI: 10.1016/j.transproceed.2015.08.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION It is well-known that patients on the liver transplant (LT) waiting list experience a high rate of psychopathologic symptoms. However, few studies have been published about the use of group psychotherapy for these patients. We sought to assess (1) the psychopathologic data in patients on the LT waiting list and (2) the attitude toward a group psychotherapy procedure and its efficacy. MATERIAL AND METHODS In the pretransplant consultation phase, group therapy was offered to 20 patients on the LT waiting list. Patients who received psychotherapy were assessed previously using the Beck Depression Inventory. RESULTS Fifteen patients were included in the study. Significant differences were found between the psychopathologic assessment and the level of hepatopathy. In the first session, we observed that patients with hepatocarcinoma were much more reluctant to participate in the group therapy. In the second session, the group showed a high level of anxiety connected with a fear of transplantation. In the third session, a transplant physician answered all their questions, and at the end of the session patient anxiety had decreased. During the following sessions, family bonds and sharing experiences with other transplant patients were emphasized. CONCLUSIONS Patients were initially reluctant to participate in the group psychotherapy, although this changed as sessions proceeded. It is necessary to provide more information about the transplant procedure itself to decrease anxiety. Group therapy was valued positively by all patients who participated.
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Affiliation(s)
- P Ramírez
- Regional Transplant Center, Consejería de Sanidad y Consumo de la Región de Murcia, Murcia, Spain; Transplant Unit, Department of General Surgery, Virgen de la Arrixaca University Hospital, Instituto Murciano de Investigaciones Biomédicas, Murcia, Spain; Department of Surgery, University of Murcia, Murcia, Spain.
| | - B Febrero
- Transplant Unit, Department of General Surgery, Virgen de la Arrixaca University Hospital, Instituto Murciano de Investigaciones Biomédicas, Murcia, Spain; Department of Surgery, University of Murcia, Murcia, Spain
| | - L Martínez-Alarcón
- Transplant Unit, Department of General Surgery, Virgen de la Arrixaca University Hospital, Instituto Murciano de Investigaciones Biomédicas, Murcia, Spain; Department of Surgery, University of Murcia, Murcia, Spain
| | - C Abete
- Transplant Unit, Department of General Surgery, Virgen de la Arrixaca University Hospital, Instituto Murciano de Investigaciones Biomédicas, Murcia, Spain
| | - M Galera
- Transplant Unit, Department of General Surgery, Virgen de la Arrixaca University Hospital, Instituto Murciano de Investigaciones Biomédicas, Murcia, Spain
| | - P Cascales
- Transplant Unit, Department of General Surgery, Virgen de la Arrixaca University Hospital, Instituto Murciano de Investigaciones Biomédicas, Murcia, Spain; Department of Surgery, University of Murcia, Murcia, Spain
| | - A I López-Navas
- Department of Psychology, Universidad Católica San Antonio (UCAM), Murcia, Spain
| | - M R González
- Transplant Unit, Department of General Surgery, Virgen de la Arrixaca University Hospital, Instituto Murciano de Investigaciones Biomédicas, Murcia, Spain
| | - A Ríos
- Transplant Unit, Department of General Surgery, Virgen de la Arrixaca University Hospital, Instituto Murciano de Investigaciones Biomédicas, Murcia, Spain; Department of Surgery, University of Murcia, Murcia, Spain
| | - J A Pons
- Transplant Unit, Department of General Surgery, Virgen de la Arrixaca University Hospital, Instituto Murciano de Investigaciones Biomédicas, Murcia, Spain
| | - P Parrilla
- Transplant Unit, Department of General Surgery, Virgen de la Arrixaca University Hospital, Instituto Murciano de Investigaciones Biomédicas, Murcia, Spain; Department of Surgery, University of Murcia, Murcia, Spain
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Fernandez AC, Fehon DC, Treloar H, Ng R, Sledge WH. Resilience in Organ Transplantation: An Application of the Connor-Davidson Resilience Scale (CD-RISC) With Liver Transplant Candidates. J Pers Assess 2015; 97:487-93. [PMID: 25915726 DOI: 10.1080/00223891.2015.1029620] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
End-stage liver disease (ESLD) is a chronic and debilitating condition associated with substantial psychological stress, morbidity, and mortality. The Connor-Davidson Resilience Scale (CD-RISC; Connor & Davidson, 2003 ) is a commonly used resilience measure. This research examined the validity of the CD-RISC among ESLD patients (N = 120) using exploratory factor analysis. Results supported a single-factor solution after removing poorly loading items. The CD-RISC also was correlated with measures of depression, anxiety, quality of life, social support, age, and cognitive ability, thus providing evidence to support its construct validity. Future research should confirm this factor structure and examine its predictive validity prior to widespread use among ESLD patients. This research represents the first step in this process and proposes an alternative version of the CD-RISC for this population.
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Affiliation(s)
- Anne C Fernandez
- a Center for Alcohol and Addiction Studies, Brown University School of Public Health
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Mohamed S, Sabki ZA, Zainal NZ. Depression and psychosocial correlates of liver transplant candidates: a systematic review. Asia Pac Psychiatry 2014; 6:447-53. [PMID: 25132651 DOI: 10.1111/appy.12145] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Accepted: 06/09/2014] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Liver transplant candidates are vulnerable to develop depression. This paper aims to ascertain the prevalence of depression in liver transplant candidates and its psychosocial factors in a systematic review. METHODS An extensive review via electronic databases (PubMed, EMBASE, CINAHL) and hand search were carried out to retrieve published articles up to December 15, 2013, using (Incidence OR Prevalence) AND Depress* AND liver transplant as the keywords. Information on the study design, patient characteristics, prevalence of depression, and its associated risk factors were extracted from included studies. RESULTS There were 22 studies included in this review with a total of 3055 patients. The prevalence of depression in the liver transplant candidates ranges between 2% and 80%. Studies that used diagnostic tools found a narrower range of prevalence (4.5-43%) as compared to the self-administered questionnaires (2-80%). Studies that used Beck Depression Inventory reported a higher prevalence than those studies which used Hospital Anxiety and Depression Scale (median = 28%, range = 2-80% versus median 17%, range 6.1-25.8%). A number of socio-demographic factors, illness-related and psychosocial factors were found to be associated with depression. CONCLUSION Prevalence of depression in liver transplant candidates is high, and early detection will improve survival and quality of life.
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Affiliation(s)
- Salina Mohamed
- Department of Psychological and Behavioural Medicine, Faculty of Medicine, University of Technology MARA (UITM), Batu Caves, Selangor, Malaysia
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Quality of life and mental health comparisons among liver transplant recipients and cirrhotic patients with different self-perceptions of health. J Clin Psychol Med Settings 2013; 20:97-106. [PMID: 22622855 DOI: 10.1007/s10880-012-9309-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Our aim was to analyze the differences in quality of life and mental health among liver transplant recipients with better (G(1)) and worse (G(2)) perceived health and decompensated cirrhotic patients (G(3)). We selected two groups of patients: 168 liver transplant recipients and 75 cirrhotic patients. The Hospital Anxiety and Depression Scale and SF-36 Health Survey were used. Statistically significant differences showed that cirrhotic patients (G(3)) suffered the highest impairment, and liver transplant recipients with better self-perceived health (G(1)) had the lowest impairment, whereas patients with worse self-perceived health (G(2)) were in an intermediate position between both groups. Moreover, very striking differences, based on large effect sizes, were found among groups on some quality of life dimensions: physical-role, general health, vitality, and physical functioning. In conclusion, the biopsychosocial well-being of liver transplant recipients is better than that of cirrhotic patients, even if the former do not perceive their health positively.
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Grover S, Sarkar S. Liver transplant-psychiatric and psychosocial aspects. J Clin Exp Hepatol 2012; 2:382-92. [PMID: 25755459 PMCID: PMC3940381 DOI: 10.1016/j.jceh.2012.08.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Accepted: 08/17/2012] [Indexed: 12/12/2022] Open
Abstract
Liver transplantation is a life saving surgical procedure that is associated with improved longevity and enhanced quality of life. The number of successful liver transplants is growing worldwide. The procedure requires a dedicated and trained team of experts. A psychiatrist plays an important role in such a team. Psychiatric and psychosocial assessment is considered imperative to evaluate the candidate's suitability as a transplant recipient. Many psychiatric disorders may lead to the need for liver transplant, and if kept unchecked can adversely affect outcomes. Psychiatric problems arising in the post-transplant period may also require intervention of the psychiatrist. The donor too needs to be evaluated adequately to assess for psychological fitness for the procedure. This article provides broad overview of the various psychiatric and psychosocial issues pertaining to liver transplantation.
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Affiliation(s)
- Sandeep Grover
- Address for correspondence: Dr. Sandeep Grover, Assistant Professor, Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh 160012, India. Tel.: +91 172 2756807 (O); fax: +91 172 2744401, +91 172 2745078.
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LI PHILIPKAMTAO, CHU KWOKHONG, CHOW KAIMING, LAU MIUFONG, LEUNG CHIBON, KWAN BONNIECHINGHA, TONG YUENFAN, SZETO CHEUKCHUN, NG MAGGIEMIUMAN. Cross sectional survey on the concerns and anxiety of patients waiting for organ transplants. Nephrology (Carlton) 2012; 17:514-8. [DOI: 10.1111/j.1440-1797.2012.01615.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Time to rethink antiviral treatment for hepatitis C in patients with coexisting mental health/substance abuse issues. Dig Dis Sci 2012; 57:1469-74. [PMID: 22484494 PMCID: PMC3683978 DOI: 10.1007/s10620-012-2141-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Accepted: 01/11/2012] [Indexed: 02/06/2023]
Abstract
BACKGROUND A new era has dawned in the treatment of chronic hepatitis C (HCV) virus with the use of direct-acting antiviral medications augmenting combination therapy. Unfortunately, the significant impact of improvements may not be realized if antiviral treatment is not expanded to include a larger proportion of patients, many of whom have coexisting mental health and/or substance abuse issues and have been historically deferred from treatment. METHODS We reviewed the extent literature on HCV treatment for individuals with co-occurring mental health and/or substance abuse issues. RESULTS A number of empirically-based arguments exist in favor of treating HCV-infected individuals with mental health and/or substance abuse issues within the context of multidisciplinary team approaches. Integrated, collaborative, or hybrid models of care are just a few examples of multidisciplinary approaches that can combine the care of HCV treating providers with mental health and/or addictions providers to safely and effectively treat these patients. Collectively, these arguments and the empirical evidence that supports them, provides a strong rationale for why expanding antiviral therapy to these patients is critical and timely. CONCLUSIONS A decade of evidence suggests that HCV-infected individuals with mental health and/or substance abuse issues can safely and effectively undergo antiviral treatment when delivered through multidisciplinary care settings. Multidisciplinary approaches that combine HCV treating providers with mental health, addictions, and other support systems can facilitate preparation and successful treatment of these patients on antiviral therapy.
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Rhodes R, Aggarwal S, Schiano TD. Overdose with suicidal intent: ethical considerations for liver transplant programs. Liver Transpl 2011; 17:1111-6. [PMID: 21563296 DOI: 10.1002/lt.22332] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Liver transplantation (LT) programs encounter patients with fulminant hepatic failure resulting from suicide attempts involving acetaminophen or multidrug ingestion. Members of transplant teams often have different opinions about whether these patients should be offered transplantation. Disagreements can delay the transfer of these patients to a transplant facility and negatively affect their management. Currently, transplant programs have no guidelines to help them with their decisions about the appropriateness of LT for these patients. Here we present a clinical case encountered at our facility, and we discuss ethical principles that should help programs to make informed decisions about transplantation for these patients.
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