Mental health and quality of life in alcoholic liver disease patients after liver transplantation: a prospective controlled study

OBJECTIVE

Alcoholic liver disease (ALD) is one of the most important indications for liver transplantation. Discordant conclusions have been found concerning quality of life and mental health after transplantation in this particular group. The aim of this work was to investigate improvements in mental health and quality of life among transplanted patients for ALD.

METHODS

We studied 45 consecutive transplant candidates with ALD, attending the outpatient clinics. Among these patients we transplanted 24 with the control candidates remaining in wait for transplantation.

RESULTS

There was a significant improvement in all mental health and quality of life dimensions among the transplanted ALD group. We also observed a favorable evolution of coping mechanisms (CM) in this group.

CONCLUSION

There is a favorable adjustment of ALD patients after transplantation as shown in CM evolution, which might explain the improved mental health and quality-of-life dimensions.

Psychiatric and psychosocial predictors of medical outcome after liver transplantation: a prospective, single-center study

OBJECTIVE

Recognizing the potential impact of psychiatric and psychosocial factors on liver transplant patient outcomes is essential to apply special follow-up for more vulnerable patients. The aim of this article was to investigate the psychiatric and psychosocial factors predicted medical outcomes of liver transplanted patients.

METHODS

We studied 150 consecutive transplant candidates, attending our outpatient transplantation clinic, including 84 who had been grafted 11 of whom died and 3 retransplanted.

RESULTS

We observed that active coping was an important predictor of length of stay after liver transplantation. Neuroticism and social support were important predictors of mortality after liver transplantation.

CONCLUSION

It may be useful to identify patients with low scores for active coping and for social support and high scores for neuroticism to design special modes of follow-up to improve their medical outcomes.

Adherence correlates in liver transplant candidates

The study sought to investigate the psychiatric and psychosocial correlates of multidimensional adherence among liver transplant candidates. A liver transplant candidate sample (N = 100), comprising consecutive patients attending outpatient clinics of a liver transplantation central unit, was assessed by means of the Multidimensional Adherence Questionnaire (MAQ; Telles-Correia 2007), the Diagnostic and Statistical Manual of Mental Disorders, Revised 4th Edition (DSM-IV-TR) criteria, the Toronto Alexithymia Scale (TAS), the NEO Five-Factor Inventory (NEO-FFI) personality inventory, the Hospital Anxiety and Depression Scale (HADS), the Brief COPE, and the Psychological Assessment of Candidates for Transplantation (PACT). We found that multidimensional adherence positively correlated with personality traits (agreeableness), good social support, and coping strategies (planning).

Psychosocial Determinants of Quality of Life 6 Months after Transplantation

Objectives:

The study sought to investigate the psychosocial determinants of quality of life 6 months after transplantation.

Methods:

A liver transplant candidates sample (n=60), comprising consecutive patients attending out-patient clinics of a liver transplantation central unit (25% of the patients had Familial Amyloid Polineuropathy (FAP) and the remaining patents had chronic liver diseases), was assessed in the pre-transplantation period by means of Neo FFI personality inventory, HADS, Brief COPE, and SF-36, a quality of life self rating questionnaire. Six months after transplantation these patients were assessed by means of SF-36.

Results:

Psychosocial predictors where found by means of multiple regression. The physical component of quality of life 6 months after transplantation was determined by coping strategies and physical quality of life in the pre transplantation period (this model explained 32% of variance) and that mental component 6 months after transplantation was determined by depression in the pre transplantation period and by clinical diagnosis of patients (FAP patients with lower mental component of quality of life) (explained 25% of the variance).

Conclusions:

Our findings suggest that coping strategies and depression measured in the pre-transplantation period are important determinants of quality of life 6 months after liver transplantation.

Further studies are needed to identify the extent to which early and continued psychotherapeutic interventions can improve not only mental but also physical related quality of life in patients at risk, for example patients with increased scores for depression and for non adaptive coping strategies in the pre transplantation period.