This article describes the pre-operative psychosocial and quality-of-life adjustment of a consecutive series of 27 heart transplant recipients and the adjustment of the 24 survivors at 12 months follow-up. Pre-operatively, 14 had a psychiatric diagnosis and this figure had dropped to five at 12 months follow-up. Those patients without a psychiatric diagnosis preoperatively had not developed one at follow-up. There was a significant correlation between pre-operative psychiatric diagnosis and a rating of poor medical compliance. Ratings of physical activity, employment and questionnaire ratings of psychological adjustment also showed highly significant improvement at follow-up and the majority of patients were active sexually. It is concluded that heart transplantation in selected subjects with terminal heart disease results in a substantial improvement in psychosocial adjustment and quality-of-life 12 months following surgery.

Objective To assess the attitudes of a random sample of Canadian psychiatrists to Multiple Personality Disorder (MPD) and assess the relative prevalence of the condition in three comparable cities in Ontario. Method A questionnaire was sent to all psychiatrists who were members of the Canadian Psychiatric Association and who were resident in Ottawa, Kingston and London. Questions were asked on the respondent's personal clinical experience of MPD and his/her attitude to this condition. Some personal and demographic questions were also included. Results 180 out of 294 questionnaires (61.2%) were returned. The existence of MPD was doubted by 27.8% of psychiatrists who responded to the questionnaire, with a significantly higher proportion in London than in Kingston or in Ottawa. A substantial majority in all three cities agreed that media publicity and the psychiatrist's own belief system affected the prevalence of MPD. Conclusion These results confirm that there is a split in the profession regarding belief in the existence of MPD as a diagnosis.

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