肾移植后的精神科会诊：日本单中心 10 年回顾性研究，包含门诊患者。

Psychiatric consultation after kidney transplantation: a 10-year single-center study including outpatients in Japan.

机构信息

Department of Psychiatry, Tokyo Women's Medical University School of Medicine, Shinjuku-ku, Tokyo, Japan.

出版信息

Int J Psychiatry Med. 2012;43(3):197-209. doi: 10.2190/PM.43.3.a.

DOI:10.2190/PM.43.3.a

PMID:22978079

Abstract

BACKGROUND

The aim of this study was to elucidate the clinical characteristics and frequency of psychiatric consultation in a routine clinical setting after kidney transplantation.

METHODS

Subjects were 1,139 consecutive recipients who received kidney transplantation at our hospital between January 1997 and September 2006. The hospital patient database was searched to determine whether these recipients received psychiatric consultation after their transplantation during this period.

RESULTS

Among 1,139 recipients, 118 (10%) received psychiatric consultation after their transplantation. There were significantly more women among these recipients (p = 0.036). Many of the recipients had received psychiatric consultation before transplantation (p < 0.0001) and had received dialysis for a long time (p = 0.018). There were three main psychiatric diagnoses according to ICD-10 diagnostic criteria in these 118 recipients: 42 (36%) had neurotic, stress-related, and somatoform disorders (F4); 35 (30%) had organic, including symptomatic, mental disorders (F0); and 27 (23%) had mood (affective) disorders (F3). The median length of time between kidney transplantation and initial psychiatric consultation was 57 days (interquartile range: 10-650 days). The lengths were 7 days (6-17 days) for F0, 75 days (18-650 days) for F4, 243 days (35-1,004 days) for F3, and 253 days (10-1,393 days) for other diagnostic groups. Significant differences were observed among these four groups (Jonckheere-Terpstra test, p < 0.001).

CONCLUSION

Our results show that appropriate psychiatric intervention is necessary not only in early stages after kidney transplantation but also over the long term.

摘要

背景

本研究旨在阐明在肾脏移植后的常规临床环境中，精神科会诊的临床特征和频率。

方法

研究对象为 1997 年 1 月至 2006 年 9 月期间在我院接受肾脏移植的 1139 例连续受者。通过医院患者数据库确定在此期间这些受者在移植后是否接受了精神科会诊。

结果

在 1139 例受者中，有 118 例（10%）在移植后接受了精神科会诊。这些受者中女性明显较多（p=0.036）。许多受者在移植前就已经接受了精神科会诊（p<0.0001），且接受透析治疗的时间较长（p=0.018）。根据 ICD-10 诊断标准，这 118 例受者中有三种主要的精神科诊断：42 例（36%）患有神经症、应激相关和躯体形式障碍（F4）；35 例（30%）患有器质性疾病，包括症状性精神障碍（F0）；27 例（23%）患有情绪（情感）障碍（F3）。从肾脏移植到首次精神科会诊的中位时间为 57 天（四分位距：10-650 天）。F0 的时间为 7 天（6-17 天），F4 的时间为 75 天（18-650 天），F3 的时间为 243 天（35-1004 天），其他诊断组的时间为 253 天（10-1393 天）。这四个组之间存在显著差异（Jonckheere-Terpstra 检验，p<0.001）。