Jowsey S G, Jacobs C, Gross C R, Hong B A, Messersmith E E, Gillespie B W, Beebe T J, Kew C, Matas A, Yusen R D, Hill-Callahan M, Odim J, Taler S J
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN; The William J. von Liebig Transplant Center, Mayo Clinic, Rochester, MN.
Am J Transplant. 2014 Nov;14(11):2535-44. doi: 10.1111/ajt.12906. Epub 2014 Oct 7.
Following kidney donation, short-term quality of life outcomes compare favorably to US normative data but long-term effects on mood are not known. In the Renal and Lung Living Donors Evaluation Study (RELIVE), records from donations performed 1963-2005 were reviewed for depression and antidepressant use predonation. Postdonation, in a cross-sectional cohort design 2010-2012, donors completed the Patient Health Questionnaire (PHQ-9) depression screening instrument, the Life Orientation Test-Revised, 36-Item Short Form Health Survey and donation experience questions. Of 6909 eligible donors, 3470 were contacted and 2455 participated (71%). The percent with depressive symptoms (8%; PHQ-9>10) was similar to National Health and Nutrition Examination Survey participants (7%, p=0.30). Predonation psychiatric disorders were more common in unrelated than related donors (p=0.05). Postdonation predictors of depressive symptoms included nonwhite race OR=2.00, p=0.020), younger age at donation (OR=1.33 per 10 years, p=0.002), longer recovery time from donation (OR=1.74, p=0.0009), greater financial burden (OR=1.32, p=0.013) and feeling morally obligated to donate (OR=1.23, p=0.003). While cross-sectional prevalence of depression is comparable to population normative data, some factors identifiable around time of donation, including longer recovery, financial stressors, younger age and moral obligation to donate may identify donors more likely to develop future depression, providing an opportunity for intervention.
肾移植后，短期生活质量结果与美国标准数据相比情况较好，但对情绪的长期影响尚不清楚。在肾与肺活体供者评估研究（RELIVE）中，回顾了1963年至2005年进行的捐赠记录，以了解捐赠前的抑郁情况和抗抑郁药使用情况。捐赠后，在2010年至2012年的横断面队列设计中，供者完成了患者健康问卷（PHQ-9）抑郁筛查工具、生活取向测试修订版、36项简短健康调查以及捐赠经历问题。在6909名符合条件的供者中，3470名被联系，2455名参与（71%）。有抑郁症状的比例（8%；PHQ-9>10）与国家健康和营养检查调查参与者相似（7%，p=0.30）。捐赠前的精神疾病在非亲属供者中比亲属供者更常见（p=0.05）。捐赠后抑郁症状的预测因素包括非白人种族（OR=2.00，p=0.020）、捐赠时年龄较小（每10年OR=1.33，p=0.002）、捐赠后恢复时间较长（OR=1.74，p=0.0009）、经济负担较重（OR=1.32，p=0.013）以及感觉有道德义务捐赠（OR=1.23，p=0.003）。虽然抑郁的横断面患病率与人群标准数据相当，但在捐赠前后可识别的一些因素，包括恢复时间较长、经济压力、年龄较小以及捐赠的道德义务，可能会识别出未来更有可能患抑郁症的供者，从而提供干预机会。
