Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA.
Department of Psychiatry and Behavioral Neurosciences, Loyola University Medical Center, Maywood, IL, USA.
Clin Transplant. 2018 Jun;32(6):e13263. doi: 10.1111/ctr.13263. Epub 2018 May 12.
Suicidality, a term referring to suicidal ideation and/or suicide attempts, has been understudied in lung transplant recipients, despite the well-documented period of high stress following transplantation. Understanding the full clinical picture of psychiatric morbidity before and after lung transplant is vital to supporting survival.
Suicidality among lung transplant recipients was examined through case studies of 5 lung transplant recipients at Loyola University Medical Center in Chicago, IL. Medical records were reviewed for demographic and psychosocial variables during the pre- and post-transplant periods to identify common factors.
Patients presented with suicidal ideation within the first 2 years of receiving lung transplantation; 4 of 5 endorsed a plan and/or intent to act and 2 made suicide attempts. Pretransplant prescription medication mismanagement, pretransplant depression or anxiety, and post-transplant depression and anxiety were each present in at least 3 of 5 cases and appeared related to the development of suicidality. Social support issues were also prominent, including changes in available supports, interpersonal distress, and social isolation or lack of support.
Patients presenting with psychiatric comorbidities or limited social support at any phase of the lung transplant process should be monitored closely. This case report draws into focus the need for systematic and ongoing psychological evaluation following lung transplantation.
尽管在移植后存在有据可查的高压力期，但在肺移植受者中，自杀倾向（指自杀意念和/或自杀尝试）的研究仍较少。了解肺移植前后精神疾病发病率的全貌对于支持生存至关重要。
通过对伊利诺伊州芝加哥洛约拉大学医学中心的 5 名肺移植受者的病例研究，检查了肺移植受者的自杀倾向。回顾了移植前后的医疗记录，以确定人口统计学和社会心理变量，以确定常见因素。
患者在接受肺移植后的头 2 年内出现自杀意念；5 名患者中有 4 名表示有计划和/或意图采取行动，其中 2 名尝试过自杀。移植前药物管理不当、移植前抑郁或焦虑以及移植后抑郁和焦虑在至少 3 例中均存在，似乎与自杀倾向的发展有关。社会支持问题也很突出，包括支持的变化、人际困扰以及社会孤立或缺乏支持。
在肺移植过程的任何阶段出现精神合并症或有限社会支持的患者都应密切监测。该病例报告重点强调了肺移植后需要进行系统和持续的心理评估。
