Alexithymia in Kidney Transplantation Patients

The relationship between alexithymia and clinical features in rhinoplasty patients

OBJECTIVE

The present study aimed to investigate the incidence of alexithymia in rhinoplasty patients before and after surgery, and to increase the value of alexithymia analysis. The study also aimed to evaluate self-esteem and rhinoplasty outcome scores together.

MATERIAL AND METHODS

Patients who had undergone rhinoplasty were enrolled in the study, and they were grouped according to gender, marital status, working status, indication (functional or aesthetic), and type of surgery (primary or revision). Toronto Alexithymia Scale-20 (TAS-20), Rosenberg Self-Esteem Scale (RSES), Rhinoplasty Outcome Evaluation (ROE), and Nasal Obstruction Symptom Evaluation (NOSE) surveys were used to assess their relationship with alexithymia.

RESULTS

We observed significantly higher alexithymia and lower self-esteem scores in females, widows, those with aesthetic indication, those who required revision surgery, and those who had never worked, and a significant correlation was observed except for marital status (p<0.05). After the surgery, significant improvement was found in TAS-20 and RSES according to preoperative scores (p<0.05). There was a significant inverse correlation between TAS-20 and ROE scores, while a positive correlation was observed between RSES and ROE scores (p<0.05).

CONCLUSION

This is the first study to investigate alexithymia changes in rhinoplasty candidates. TAS-20 can be considered as a useful survey to assess psychological distress in rhinoplasty candidates.

Psychological and Psychopathological Aspects of Kidney Transplantation: A Systematic Review

Kidney transplantation is a serious event that involves profound psychological, relational and social changes both for the patient and his family context. Assessment of personality profile, awareness of disease, family and social support of the patient candidate for kidney transplantation are necessary because factors not adequately considered, can influence the success of the transplant and alter the psychological stability of the patient. The present study aims to provide a systematic review of the literature of the last twelve years (2006-2018), focusing in particular on patient's readiness level and illness management and on possible psychopathology. Sixty-two studies were examined. Based on the Downs and Black checklist, most studies (n = 32) were of high quality; 15 of which related to lifestyle, health education, and therapeutic adherence in post-renal transplantation, 17 studies concerned the possible existence of psychopathology and cognitive impairment of renal deceased transplanted subjects. The literature used has shown that the population of kidney transplant patients is exposed to a high risk of psychiatric disorders with repercussions on the quality of life and the risk of rejection. Therefore, an adequate pre-transplant psychosocial assessment is necessary, which allows a more in-depth knowledge of the candidate to plan coping strategies and possible post-transplant psychotherapy.

Impact of Alexithymia on Organ Transplant Candidates' Quality of Life: The Mediating Role of Depressive Symptoms

Solid organ transplant candidates who display alexithymia tend to report psychological distress with some displaying symptoms associated with depression which in turn has a negative impact on their quality of life. This study sought to examine the mediating role of depression on the relationship between alexithymia and physical and psychological quality of life. The sample comprised 707 patients who were under consideration for solid organ transplantation. Mediation models were used to examine the proposed hypotheses, specifically that alexithymia would predict quality of life, and that depression would mediate the relationship between alexithymia and physical and psychological quality of life. Findings revealed that alexithymia predicted both physical and psychological quality of life. Depression scores partially mediated the relationship between alexithymia and both physical and psychological quality of life. Transplant candidates with higher levels of alexithymia who report poor physical and psychological quality of life may be at increased risk for depression. Results highlight the need to assess alexithymia within this unique patient population, who may understate symptoms of depression due to attempts at positive impression management.

Influence of Selected Biomarkers on Stress and Alexithymia in Patients Under Hemodialysis Treatment

Background

Hemodialysis treatment and the high stress brought about by the treatment are the circumstances which set the background for alexithymia. Alexithymic feelings basically emerge as restriction in the world of emotion and thought, and the inability to recognize physiological changes. Biomarkers that are indicators of physical change are influential in the stress lives of individuals. This research was carried out to discover the relationships between, and to determine the influence of urea, creatinine, sodium, potassium, hemoglobin, hematocrit, albumin, calcium, phosphorus and C-reactive protein biomarkers on stress and alexithymia in individuals, who are diagnosed with chronic renal failure and receive hemodialysis treatment.

Methods

The research environment was formed of patients who underwent hemodialysis treatment in a hospital in Turkey. The subject group was comprised of 72 individuals. Demographic data form, biomarker list form, Hemodialysis Stressor Scale and Toronto Alexithymia Scale were used in the research.

Results

It was found that the levels of perceived stress of individuals who participated in the research were high at all dimensions, and 59.7% were alexithymic. The means of the total scale scores of all patients were calculated as 87.81 ± 13.59 for Hemodialysis Stressor Scale and 62.46 ± 9.84 for Toronto Alexithymia Scale. The relationship between the Toronto Alexithymia Scale and Hemodialysis Stressor Scale and selected biomarkers were determined (P < 0.05).

Conclusion

It was concluded that stress and alexithymic feelings were high in patients who received hemodialysis treatment, and that there is a relationship between C-reactive protein, creatinine, sodium, hemoglobin, hematocrit, potassium from the biomarkers and the scales and scale sub-dimensions. It is necessary to increase the awareness of nurses on the importance of the skills to communicate with individuals who have to cope with stress, manage emotions, and have high stress and emotional deprivation.

Nonverbal Communication and Psychopathology in Kidney Transplant Recipients

Transplant recipients have difficulty expressing, identifying, and describing their emotional experiences. The Machover human figure test allows us to bring out the deepest contents of a patient's personality, which are normally hidden and not explained to structured quantitative tests. The study analyzed possible situations of distress and possible symptoms of psychopathology in kidney transplant recipients, emerged from the projective test of the human figure and not easily verbalized to the common standardized tests. The sample included 80 kidney transplant patients (51 men and 29 women; mean age, 47.74 [SD, 12.39] years) during follow-up visits at 12 months after transplant. The Machover test was used to evaluate body image, affective aspects, and personality variables by projective method; the Symptom Checklist-90-R was used for the evaluation of possible psychopathology, and the 36-Item Short Form Health Survey was used for the assessment of perceived quality of life. RESULTS: showed that the more anxiety there is in the human figure test, the less somatization dimensions (ANX/SOM R = -331, P < .05), depression (ANX/DEP R = -326, P < .05), and the global index of psychic symptomatology (ANX/GSI R = -367, P < .05) of the Symptom Checklist-90-R are present. This research has confirmed the hypothesis that the spontaneous graphic production of the recipients, through the projective methods, allows them to identify and deepen their psychological contents and to activate and maintain a good psychophysical balance post transplant.