Pascazio L, Nardone I B, Clarici A, Enzmann G, Grignetti M, Panzetta G O, Vecchiet C
Department of Medical, Technological and Translational Science, University of Trieste, Trieste, Italy.
Transplant Proc. 2010 Nov;42(9):3586-90. doi: 10.1016/j.transproceed.2010.08.056.
Renal transplantation is a well established treatment for end-stage renal disease. However, recipients have been shown to develop emotional distress and affective disorders, such as anxiety and depression, associated with a compromised quality of life. Some accounts report an improvement of affective disorders after transplantation, others draw opposite conclusion.
The present cross-sectional study selected 42 transplant recipients and 42 control subjects matched for gender, age, educational background, and marital status. Symptoms of anxiety, depression and general emotional profiles were compared using the Zung Self-Rating Anxiety Scale, the Beck Depression Inventory (BDI), and the Affective Neuroscience Personality Scale (ANPS), a self-report inventory that evaluates 6 neurally based affective tendencies: seeking, caring, and playfulness (positive affects) and fear, anger, and sadness (negative affects).
No significant differences were observed between transplanted patients and controls in scores for anxiety and depression, as evaluated with Zung and BDI scales. However, transplanted patients scored significantly lower than control subjects in fear and anger scales and in general negative emotions. Transplant recipients did not display any symptom of anxiety or depression, however, a significant reduction in negative affect, evaluated through the ANPS scale revealed psychological distress.
These findings suggest that affective profile in transplanted patients should be more extensively examined to review all facets in their mental and emotional assessment, especially regarding the role played by this emotional pattern in complying with medical treatment, which is well known to be a clinically critical feature of these patients.
肾移植是终末期肾病的一种成熟治疗方法。然而,已表明接受者会出现情绪困扰和情感障碍,如焦虑和抑郁,这与生活质量受损有关。一些报道称移植后情感障碍有所改善,另一些则得出相反结论。
本横断面研究选取了42名移植受者和42名在性别、年龄、教育背景和婚姻状况方面相匹配的对照者。使用zung自评焦虑量表、贝克抑郁量表(BDI)和情感神经科学人格量表(ANPS)比较焦虑、抑郁症状和一般情绪状况,ANPS是一种自评量表,评估6种基于神经的情感倾向:寻求、关爱和好玩(积极情感)以及恐惧、愤怒和悲伤(消极情感)。
用zung量表和BDI量表评估时,移植患者和对照者在焦虑和抑郁评分上无显著差异。然而,移植患者在恐惧和愤怒量表以及一般消极情绪方面的得分显著低于对照者。移植受者未表现出任何焦虑或抑郁症状,然而,通过ANPS量表评估发现消极情感显著减少,这表明存在心理困扰。
这些发现表明,应更广泛地检查移植患者的情感状况,以全面评估其心理和情绪的各个方面,特别是这种情绪模式在遵医嘱治疗中所起的作用,众所周知,这是这些患者临床上的一个关键特征。