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酒精性肝病患者肝移植后的心理社会功能

Psychosocial functioning in patients with alcohol-related liver disease post liver transplantation.

作者信息

Pegum Nell, Connor Jason P, Young Ross McD, Feeney Gerald F X

机构信息

Alcohol and Drug Assessment Unit, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia.

Alcohol and Drug Assessment Unit, Princess Alexandra Hospital, Brisbane, QLD 4102, Australia; Centre for Youth Substance Abuse Research, The University of Queensland, QLD 4029, Australia; Discipline of Psychiatry, The University of Queensland, QLD 4029, Australia.

出版信息

Addict Behav. 2015 Jun;45:70-3. doi: 10.1016/j.addbeh.2015.01.021. Epub 2015 Jan 20.

Abstract

Emotional and role functioning difficulties are associated with chronic alcohol use and liver disease. Little is known about prospective changes in psychological and psychosocial functioning following orthotopic liver transplantation (OLT) amongst patients with alcoholic liver disease (ALD). We aimed to assess the functioning of this patient group post liver transplantation. Comprehensive psychosocial assessment of depression (Beck Depression Inventory [BDI]), anxiety (State-Trait Anxiety Inventory-Form X [STAI]) and psychosocial adjustment (Psychosocial Adjustment to Illness Scale-Self-Report version [PAIS-SR]) was conducted with 42 ALD patients available for pre and post OLT testing. Dependence severity was assessed by the Brief Michigan Alcoholism Screening Test (bMAST). Significant reductions in average anxiety and depression symptoms were observed 12-months post-OLT. Significant improvements in psychosocial adjustment to illness were also reported. Patients with higher levels of alcohol dependence severity pre transplant assessment improved comparably to those with lower levels of dependence. In summary, the study found that OLT contributed to reducing overall levels of mood and anxiety symptoms in ALD patients, approximating general (non-clinical) population norms. Psychosocial adjustment also improved significantly post liver transplantation.

摘要

情绪和角色功能障碍与慢性酒精使用及肝脏疾病相关。对于酒精性肝病(ALD)患者原位肝移植(OLT)后心理和社会心理功能的前瞻性变化知之甚少。我们旨在评估该患者群体肝移植后的功能状况。对42例可进行OLT术前和术后测试的ALD患者进行了抑郁(贝克抑郁量表[BDI])、焦虑(状态-特质焦虑量表-X型[STAI])和社会心理适应(疾病社会心理适应量表-自我报告版[PAIS-SR])的综合社会心理评估。通过简明密歇根酒精ism筛查测试(bMAST)评估依赖严重程度。OLT术后12个月观察到平均焦虑和抑郁症状显著减轻。还报告了疾病社会心理适应方面的显著改善。移植前评估中酒精依赖严重程度较高的患者与依赖程度较低的患者改善程度相当。总之,该研究发现OLT有助于降低ALD患者的总体情绪和焦虑症状水平,接近一般(非临床)人群标准。肝移植后社会心理适应也显著改善。

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