Lopes A, Frade I C, Teixeira L, Oliveira C, Almeida M, Dias L, Henriques A C
Lyaison-Psychiatry and Health Psychology Unit, Oporto Hospital Centre, Oporto, Portugal.
Transplant Proc. 2011 Jan-Feb;43(1):131-6. doi: 10.1016/j.transproceed.2010.12.028.
Psychosocial status of donors before and after living kidney donor transplantation has been an important concern. Investigations of psychosocial issues in related recipients are not frequent.
The aims of this study were to evaluate and compare psychopathologic dimensions in donors and recipients before and after transplantation.
Thirty-five recipients and 45 donors completed a psychosocial evaluation before and after transplantation. We applied Pearson chi-square, McNemar, Fisher, Wilcoxon, and Mann-Whitney tests as well as linear and logistic regression statistical methods.
Before transplantation 100% of the recipients presented total anxiety, compared with 64.4% of donors, with higher anxiety levels in all dimensions (P < .001). Also, 38.7% of recipients and 16.3% of donors had moderate/serious depression (P = .029). Men showed higher levels of cognitive anxiety before transplantation (odds ratio [OR] = 4.3; P = .008). After versus before transplantation central nervous system and cognitive anxiety had diminished in recipients (P = .031; P = .035, respectively); there were higher levels of cognitive anxiety than among the donors (P = .007). Depression showed no significant changes in recipients or donors; the differences were no longer significant. There were less severely depressed recipients but an increase among severely depressed donors. Male recipients and donors showed greater cognitive anxiety (P = .02; P = .04, respectively) at both times. Female recipients presented with more severe depression (P = .036).
Anxiety is an important symptom. Surgery had a positive impact to lower anxiety in recipients. Most protagonists displayed little or no depression; it was more prevalent among recipients. Donors and recipients maintained some psychopathologic symptoms after surgery. We defined vulnerable groups among these cohorts.
活体肾移植供体术前及术后的心理社会状况一直是重要关注点。对相关受者心理社会问题的调查并不常见。
本研究旨在评估并比较移植前后供体和受者的心理病理维度。
35名受者和45名供体在移植前后完成了心理社会评估。我们应用了Pearson卡方检验、McNemar检验、Fisher检验、Wilcoxon检验、Mann-Whitney检验以及线性和逻辑回归统计方法。
移植前，100%的受者存在总体焦虑，而供体为64.4%，所有维度的焦虑水平均更高（P <.001）。此外，38.7%的受者和16.3%的供体有中度/重度抑郁（P =.029）。男性在移植前表现出更高水平的认知焦虑（优势比[OR]=4.3；P =.008）。与移植前相比，移植后受者的中枢神经系统焦虑和认知焦虑有所减轻（分别为P =.031；P =.035）；认知焦虑水平高于供体（P =.007）。抑郁在受者或供体中均无显著变化；差异不再显著。抑郁严重程度较轻的受者数量减少，但抑郁严重的供体数量增加。男性受者和供体在两个时间点均表现出更高的认知焦虑（分别为P =.02；P =.04）。女性受者的抑郁更严重（P =.036）。
焦虑是一个重要症状。手术对降低受者的焦虑有积极影响。大多数参与者表现出很少或没有抑郁；抑郁在受者中更普遍。供体和受者在术后仍存在一些心理病理症状。我们在这些队列中确定了脆弱群体。
