Davydow Dimitry S, Lease Erika D, Reyes Jorge D
Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Washington, Seattle, WA, USA.
Gen Hosp Psychiatry. 2015 Sep-Oct;37(5):387-98. doi: 10.1016/j.genhosppsych.2015.05.005. Epub 2015 May 28.
To summarize and critically review the existing literature on the prevalence of posttraumatic stress disorder (PTSD) following organ transplantation, risk factors for posttransplantation PTSD and the relationship of posttransplant PTSD to other clinical outcomes including health-related quality of life (HRQOL) and mortality.
We conducted a systematic literature review using PubMed, CINAHL Plus, the Cochrane Library and PsycInfo and a search of the online contents of 18 journals.
Twenty-three studies were included. Posttransplant, the point prevalence of clinician-ascertained PTSD ranged from 1% to 16% (n=738), the point prevalence of questionnaire-assessed substantial PTSD symptoms ranged from 0% to 46% (n=1024) and the cumulative incidence of clinician-ascertained transplant-specific PTSD ranged from 10% to 17% (n=482). Consistent predictors of posttransplant PTSD included history of psychiatric illness prior to transplantation and poor social support posttransplantation. Posttransplant PTSD was consistently associated with worse mental HRQOL and potentially associated with worse physical HRQOL.
PTSD may impact a substantial proportion of organ transplant recipients. Future studies should focus on transplant-specific PTSD and clarify potential risk factors for, and adverse outcomes related to, posttransplant PTSD.
总结并批判性地回顾关于器官移植后创伤后应激障碍（PTSD）患病率、移植后PTSD的危险因素以及移植后PTSD与包括健康相关生活质量（HRQOL）和死亡率在内的其他临床结局之间关系的现有文献。
我们使用PubMed、CINAHL Plus、Cochrane图书馆和PsycInfo进行了系统的文献综述，并搜索了18种期刊的在线内容。
纳入了23项研究。移植后，临床医生确诊的PTSD的时点患病率为1%至16%（n = 738），问卷调查评估的显著PTSD症状的时点患病率为0%至46%（n = 1024），临床医生确诊的移植特异性PTSD的累积发病率为10%至17%（n = 482）。移植后PTSD的一致预测因素包括移植前的精神疾病史和移植后的社会支持差。移植后PTSD一直与较差的心理HRQOL相关，并且可能与较差的身体HRQOL相关。
PTSD可能影响相当一部分器官移植受者。未来的研究应关注移植特异性PTSD，并阐明移植后PTSD的潜在危险因素以及与之相关的不良结局。
