Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Int J Psychiatry Clin Pract. 2008;12(2):120-6. doi: 10.1080/13651500701749842.
Objective. Adult recipients of living donor liver transplantation (LDLT) often have psychiatric disorders before and after surgery. The aim of this study was to investigate pretransplant psychosocial factors that can be used to predict psychiatric disorders after LDLT. Methods. The subjects were 67 recipients of adult-to-adult LDLT at Kyoto University Hospital, Japan, from November 2001 through July 2003. All subjects were interviewed and examined by means of the Beck Depression Inventory, State-Trait Anxiety Inventory, World Health Organization Quality-of-Life Assessment-26, and Psychosocial Assessment of Candidates for Transplantation (PACT) just before LDLT. The subjects were followed up for 90 days for the presence of psychiatric disorders. Results. Mood disorders in the past, inability to maintain a healthy lifestyle, family support instability, and suicidal ideation just before LDLT might be predictors of major depressive disorder after LDLT. Delirium just before LDLT might be a predictor of delirium after LDLT, while no psychosocial factors associated with posttransplant delirium could be found. Conclusion. Information about life history rather than any psychological examination is important for predicting the occurrence of posttransplant depression. PACT is useful for obtaining information about the life history of LDLT recipients.
成人活体肝移植（LDLT）受者在手术前后常伴有精神障碍。本研究旨在探讨移植前的社会心理因素，以预测 LDLT 后的精神障碍。
本研究对象为 2001 年 11 月至 2003 年 7 月在日本京都大学医院接受成人对成人 LDLT 的 67 例受者。所有受者在 LDLT 前均通过贝克抑郁量表、状态特质焦虑量表、世界卫生组织生活质量评估 26 项和候选者心理社会评估（PACT）进行访谈和检查。对受者进行了 90 天的随访，以确定是否存在精神障碍。
移植前的心境障碍史、无法维持健康的生活方式、家庭支持不稳定和自杀意念可能是 LDLT 后发生重度抑郁症的预测因素。移植前的谵妄可能是 LDLT 后谵妄的预测因素，而未发现与移植后谵妄相关的任何心理社会因素。
与心理检查相比，生活史信息对于预测移植后抑郁的发生更为重要。PACT 有助于获取 LDLT 受者生活史的信息。
