Psychiatric symptoms in renal transplant patients in relation to alexithymia

Kubo, Masako; Kawai, Mieko; Sakuraba, S.; Mori, Nicole; Oguri, Kayoko; Komoda, Takeshi

doi:10.1016/s0041-1345(01)02509-x

Cited by 9 publications

(5 citation statements)

References 12 publications

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“…These depressive symptoms, in turn, may partly contribute to a reduction in the patient’s QOL. These findings support past research on the association between alexithymia and depression (Calia et al., 2015; Kubo et al., 2001; Torres et al., 2015). Implications from this study signify the value of early assessment and detection of alexithymia among solid organ transplant candidates as these factors may negatively affect posttransplant outcomes such as adherence and graft failure (Dew et al., 2016; DiMartini et al., 2011; Dobbels et al., 2009; Lumley et al., 2007).…”

Section: Discussionsupporting

confidence: 91%

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

et al. 2019

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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.

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Section: Discussionsupporting

confidence: 91%

“…(2010) detected higher levels of alexithymia in lung transplant recipients in comparison to a community sample. Other studies with transplant samples established a relationship between alexithymia and psychological dysfunction, lower QOL, and poor medical adherence (Calia et al., 2015; Kubo et al., 2001). Calia et al.…”

Section: Alexithymiamentioning

confidence: 99%

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

et al. 2019

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“…Alexithymia (an inability to process or communicate emotions) has been described in a high proportion of renal transplant recipients (18), which has been associated with non-adherence.…”

Section: Discussionmentioning

confidence: 99%

“…Although non-adherence is not reliably listed as a cause of death after renal transplantation, non-adherence as a specified cause of graft loss was significantly more common in patients hospitalized for psychosis than in patients not hospitalized for psychosis, and specific causes of graft loss have been utilized in previous studies (18). The increased risk of mortality among patients hospitalized for psychosis was independent of graft loss, suggesting a role for other factors, possibly including non-adherence with non-immunosuppressive medications as well.…”

Section: Discussionmentioning

confidence: 99%

Hospitalized Psychoses after Renal Transplantation in the United States

Abbott¹,

Agodoa

O’Malley

2003

Journal of the American Society of Nephrology

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ABSTRACT. Although it is recommended that renal transplant (RT) candidates routinely undergo screening for mental health–related conditions, national statistics for psychoses after RT have not been reported. This is a historical cohort study of 39,628 renal transplant recipients in the United States Renal Data System between July 1, 1994, and June 30, 1998, and followed until December 31, 1999. Adjusted hazard ratios (AHR) for time to hospitalization for both a primary and secondary discharge diagnosis of psychoses (ICD-9 codes 290.x-299.x) after RT and mortality/graft loss after psychosis were assessed by Cox Regression. In addition, rates of psychosis were compared with 178,986 patients with Medicare as their primary payer who started chronic dialysis from April 1, 1995, to June 29, 1999. The incidence of psychoses was 7.5/1000 person-years (PY) after RT compared with 7.2/1000 PY for all patients on chronic dialysis and 9.6/1000 PY for dialysis patients aged 65 yr or younger. Among RT recipients, graft loss (AHR, 2.97; 95% CI, 2.19 to 4.02), allograft rejection, and cadaveric donation were independently associated with psychosis, which was associated with an increased risk of both death (AHR, 2.09; 95% CI, 1.71 to 2.56; P < 0.001) and graft loss (AHR, 1.79; 95% CI, 1.15 to 2.78; P = 0.01). Graft loss due to noncompliance was significantly more common after psychosis (9.0% versus 3.7% in patients not hospitalized for psychosis; P < 0.001). The incidence of hospitalized psychosis was not substantially higher after RT compared with chronic dialysis patients. Psychoses were independently associated with increased risk of death and graft loss after renal transplantation, possibly mediated through medical non-adherence. E-mail: kevin.abbott@na.amedd.army.mil

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“…The high prevalence rate of psychiatric disorders and relevant psychosocial conditions supported the need to use a tool to assess physical and psychological symptoms of distress in KTRs. The urgency for standardized psychiatric and psychosocial screening for distress in KTRs is also supported by the high prevalence of alexithymia [20], defined as a difficulty in identifying and describing emotions. The most commonly used psychiatric screening tools are however time-consuming and difficult for patients to complete [21][22][23][24][25][26][27].…”

Section: Introductionmentioning

confidence: 99%

Screening Performance of Edmonton Symptom Assessment System in Kidney Transplant Recipients

Battaglia

Zerbinati

Piazza

et al. 2020

JCM

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An average prevalence of 35% for psychiatric comorbidity has been reported in kidney transplant recipients (KTRs) and an even higher prevalence of other psychosocial syndromes, as defined by the Diagnostic Criteria for Psychosomatic Research (DCPR), has also been found in this population. Consequently, an easy, simple, rapid psychiatric tool is needed to measure physical and psychological symptoms of distress in KTRs. Recently, the Edmonton Symptom Assessment System (ESAS), a pragmatic patient-centred symptom assessment tool, was validated in a single cohort of KTRs. The aims of this study were: to test the screening performances of ESAS for the International Classification of Diseases-10th Revision (ICD-10) psychiatric diagnoses in KTRs; to investigate the optimal cut-off points for ESAS physical, psychological and global subscales in detecting ICD-10 psychiatric diagnoses; and to compare ESAS scores among KTR with ICD-10 diagnosis and DCPR diagnosis. 134 KTRs were evaluated and administered the MINI International Neuropsychiatric Interview 6.0 and the DCPR Interview. The ESAS and Canadian Problem Checklist (CPC) were given as self-report instruments to be filled in and were used to examine the severity of physical and psychological symptoms and daily-life problems. The physical distress sub-score (ESAS-PHYS), psychological distress sub-score (ESAS-PSY) and global distress score (ESAS-TOT) were obtained by summing up scores of six physical symptoms, four psychological symptoms and all single ESAS symptoms, respectively. Routine biochemistry, immunosuppressive agents, socio-demographic and clinical data were collected. Receiving Operating Characteristic (ROC) analysis was used to examine the ability of the ESAS emotional distress (DT) item, ESAS-TOT, ESAS-PSY and ESAS-PHYS, to detect psychiatric cases defined by using MINI6.0. The area under the ROC curve for ESAS-TOT, ESAS-PHYS, ESAS-PSY and DT item were 0.85, 0.73, 0.89, and 0.77, respectively. The DT item, ESAS-TOT and ESAS-PSY optimal cut-off points were ≥4 (sensitivity 0.74, specificity 0.73), ≥20 (sensitivity 0.85, specificity 0.74) and ≥12 (sensitivity 0.85, specificity 0.80), respectively. No valid ESAS-PHYS cut-off was found (sensitivity <0.7, specificity <0.7). Thirty-nine (84.8%) KTRs with ICD-10 diagnosis did exceed both ESAS-TOT and ESAS-PSY cut-offs. Higher scores on the ESAS symptoms (except shortness of breath and lack of appetite) and on the CPC problems were found for ICD-10 cases and DCRP cases than for ICD-10 no-cases and DCPR no-cases. This study shows that ESAS had an optimal screening performance (84.8%) to identify ICD-10 psychiatric diagnosis, evaluated with MINI; furthermore, ESAS-TOT and ESAS-PSY cut-off points could provide a guide for clinical symptom management in KTRs.

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Psychiatric symptoms in renal transplant patients in relation to alexithymia

Cited by 9 publications

References 12 publications

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

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

Hospitalized Psychoses after Renal Transplantation in the United States

Screening Performance of Edmonton Symptom Assessment System in Kidney Transplant Recipients

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