Psychiatric Aspects of Heart Transplantation

Levenson, James L.; Olbrisch, Mary Ellen

doi:10.1016/s0033-3182(93)71901-5

Cited by 61 publications

(28 citation statements)

References 34 publications

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“…During the first days of hospitalization, it is often possible to find neurological and psychiatric complications. Transient syndromes such as delirium, hallucinations, memory loss and periods of unconsciousness have also been described in nearly 25% of patients who underwent heart transplantation [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

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Psychological Evaluation after Cardiac Transplantation: The Integration of Different Criteria

Grandi

Fabbri

Tossani

et al. 2001

Psychother Psychosom

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Background: The psychological evaluation of patients undergoing cardiac transplantation is currently based on DSM-IV criteria. An alternative diagnostic and conceptual framework has been proposed by an international group of psychosomatic investigators. The aim of this study was to compare these new criteria (Diagnostic Criteria for Psychosomatic Research, DCPR) with DSM-IV in a population where a high prevalence of psychological problems is expected (heart-transplanted patients). Method: 129 consecutive patients who underwent heart transplant surgery were assessed according to DSM-IV and DCPR criteria. Results: The results showed a higher number of diagnoses made using the DCPR than with the use of the DSM-IV. At least one DCPR diagnosis was found in 85 (66%) patients, whereas at least one DSM diagnosis was present in 23 (18%) patients. The number of DCPR diagnoses was almost the triple of DSM criteria. While patients who were given a DSM diagnosis frequently had additional DCPR diagnoses, many patients with DCPR criteria did not fulfill any DSM criteria. Four DCPR syndromes appeared to be particularly frequent: demoralization, type A behavior, irritable mood and alexithymia. Conclusions: The joint use of DSM and DCPR criteria was found to improve the identification of psychological factors which could result in a worsening of quality of life in heart-transplanted patients.

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Section: Introductionmentioning

confidence: 99%

“…The fears of rejection, of infection, of a tumor or death are all factors which could lead to an increase in anxiety levels. Anxiety could also be a symptom that characterizes acute rejection reactions [6].…”

Section: Introductionmentioning

confidence: 99%

Psychological Evaluation after Cardiac Transplantation: The Integration of Different Criteria

Grandi

Fabbri

Tossani

et al. 2001

Psychother Psychosom

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“…These depressed patients present a higher risk for noncompliance, either unconsciously or as a deliberate suicidal act that may not be detected [15]. Furthermore, the somatic status after transplantation and the limitations in social and everyday life could contribute to their level of psychological distress.…”

Section: Discussionmentioning

confidence: 99%

Psychological distress of surgical patients after orthotopic heart transplantation

Triffaux¹,

Wauthy²,

Albert³

et al. 2001

Transplant International

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Orthotopic heart transplantation (OHT) is a major surgical intervention inducing distress and anxiety. Psychological problems after OHT have been described in many studies. Little is known, however, about the relationship between the psychological state of the patient and time after surgery. The present study involved 41 consecutive OHT patients that underwent transplantation from January 1992 to December 1992, with a retrospective review of pretransplant psychiatric evaluations to define a Diagnostic and Statistical Manual of Mental Disorders, 3rd edn., revised (DSM 111-R) Axis I diagnosis. Patients completed the Beck Depression Znventory (BDI-13), Spielberger's State Trait-Anxiety Inventory (STAI-Y), and the General Health Questionnaire (GHQ-28) between 1 and 41 months after transplantation. For comparison, 29 presumably healthy volunteers were given the same questionnaires. The study confirms the occurrence of abnormal psychological scores in the OHT group as compared to the reference population.Psychological scores, however, do not appear to be related to the time they were recorded after surgery.

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“…En la revisión de la literatura realizada por Ballester (1999) se señalan los siguientes aspectos psicológicos manifestados por los pacientes con VIH: baja autoestima, miedo a perder el atractivo físico e hipocondría (Morin, Charles y Malyon, 1984); negación, ira, aceptación, resignación y preparación para la muerte (Nichols, 1983) expresando una evolución similar a la que se produce en los enfermos terminales (Kim y Rickman, 1988;Levenson, 1988); somatización, síntomas obsesivo-compulsivos (Bruce y Stevens, 1992;Krikorían, Kay y Liang, 1995); reaparición de conflictos sobre la orientación homosexual y exacerbación de la homofobia (Ross y Rosser, 1988); disminución de la concentración y pérdida de memoria (Naber ct al., 1989;King, 1989;Ayers, Abrams, Newell y Friedrich, 1989;Kermani, Borod, Brown y'I\umell, 1985); ibbias específicas, trastorno de personalidad antisocial, deseo sexual hipoactivo (Green, 1994); abuso del alcohol (Pace, Brown, Rundell, Paolucci et al, 1990); problemas de sueño, desmoralización, uso excesivo de sedantes (Martin y Dean, 1993), consumo de drogas, etc.…”

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“…Parece que de todos los trastornos, los cuadros afectivos mixtos, con síntomas de ansiedad y depresión, son los trastornos psicológicos que con mayor frecuencia se describen en los pacientes con SIDA (Levenson, 1988;Weinrich, Atkinson, McCutchan y Grant, 1995;Remor, Carrobles, Arranz, Dónate y Ulla, 2001;Morrison et al, 2002;Martin et al, 2002). Su presencia está asociada, a su vez, con factores psicosociales, como la disponibilidad o no de apoyo social, la propia percepción sobre la enfermedad, y el deterioro físi-co provocado por la evolución de la infección (Bor, 1991).…”

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Estado emocional y conducta de enfermedad en pacientes con VIH/SIDA y enfermos oncológicos

Alarcón

Ballester‐Arnal²

2006

RPPC

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Resanen: El objetivo del ptesente trabajo es ofrecer datos relativos al estado emocional y la conducta de enfermedad de personas con infección por VIH en comparación con pacientes oncológi-eos y población general. La muestra utilizada es de 180 sujetos. Los instnanentos aplicados evalú-an: ansiedad rasgo y estado, depresión, autoestima, conducta anormal de enfermedad, percepción de apoyo social y grado de interferencia de la enfermedad. Los resultados indican que los pacientes seropositivos muestran un perfil psicológico con mayor grado de ansiedad estado y rasgo y niveles de depresión significativamente más altos que los otros grupos, asi como una autoestima significativamente menor. Asimismo, los pacientes con infección por VIH manifiestas mayor preocupación por su salud, percepción de apoyo social significativamente menor que la de los pacientes oncológicos y también mayor grado de interferencia de la enfermedad en sus vidas. Se concluye la necesidad de un abordaje terapéutico especifico para los pacientes con VIH que tenga en consideración su perfil diferencial respecto a otras enfermedades consideradas como graves.Palabras clave: Conducta de enfermedad, estado emocional, infección por VIH, cáncer. Emotional distress and illness behavior in HIV/ÁIDS and cantxr patíentsAbstract: The aim of this paper is to present data as to emotional distress and illness behavior of HIV patients w^en oon^Kired to cáncer patients and the general population. The sample consisted of 180 subjects. Questionnaires were used to evalúate: trait anxiety, state anxiety, dq>ression, selfesteem, abnormal illness behavior, perceived social support and interference through illness. The results indícate that HIV patients have a psychological profile with higher trait and state anxiety, signiflcantly higher levéis of depression, and significantly lower self-esteem duin the other groups. Furthermore, HTV patients worry more about their health, peroeive significantly less social 8iq>port than cáncer patients and a higher interference from the illness in their Uves. Our conclusión points at the need for a specific therapeutic approach for HIV patients that takes into consideration their diflferential profile when compared to other major diseases.Keywords: Illness behavior, «notional distress, HIV infection, cáncer. INTRODUCCIÓNMuchas personas a las que se les diagnostica el VIH, especialmente por el estigma asociado a esta enfermedad, reciben el diagnóstico como una sentencia de muerte que, cuanto menos, les ocasiona importantes desequilibrios en su vida personal. Los cambios físicos y psicológicos producidos por la infección del VIH y su trata-

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Psychiatric Aspects of Heart Transplantation

Cited by 61 publications

References 34 publications

Psychological Evaluation after Cardiac Transplantation: The Integration of Different Criteria

Psychological Evaluation after Cardiac Transplantation: The Integration of Different Criteria

Psychological distress of surgical patients after orthotopic heart transplantation

Estado emocional y conducta de enfermedad en pacientes con VIH/SIDA y enfermos oncológicos

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