Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-23T05:07:50.276Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychological evolution and assessment in patients undergoing orthotopic heart transplantation

Published online by Cambridge University Press:  16 April 2020

J.M. Triffaux ,
J. Wauthy ,
J. Bertrand ,
R. Limet ,
A. Albert  and
M. Ansseau
J.M. Triffaux*
Affiliation:
Department of Psychiatry, Psychological and Psychosomatic Medicine, CHU du Sart Tilman, University of Liège, Liège, Belgium
J. Wauthy
Affiliation:
Department of Psychiatry, Psychological and Psychosomatic Medicine, CHU du Sart Tilman, University of Liège, Liège, Belgium
J. Bertrand
Affiliation:
Department of Psychiatry, Psychological and Psychosomatic Medicine, CHU du Sart Tilman, University of Liège, Liège, Belgium
R. Limet
Affiliation:
Department of Heart Surgery, CHU du Sart Tilman, University of Liège, Liège, Belgium
A. Albert
Affiliation:
Department of Biostatistics, CHU du Sart Tilman, University of Liège, Liège, Belgium
M. Ansseau
Affiliation:
Department of Psychiatry, Psychological and Psychosomatic Medicine, CHU du Sart Tilman, University of Liège, Liège, Belgium
*
*Correspondence and reprints: Dr J.M. Triffaux, Hôpital de Jour Universitaire ‘La Clé’, 153 boulevard de la Constitution, 4020 Liège, Belgium. E-mail address: [email protected] (J.M. Triffaux).
Get access

Summary

Background. Orthotopic heart transplantation (OHT) is a major surgical intervention inducing distress and anxiety. Psychiatric evaluation of organ transplant candidates is now routinely proposed. This study purposed to assess the psychological evolution in patients having received psychological and/or psychiatric assistance before and during 1–6 postoperative months. Methods. Twenty-two consecutive transplant candidates were psychically evaluated as part of the preoperative protocol. In the waiting period, 1 and 6 months after OHT, they were asked to fill out the following questionnaires: the General Health Questionnaire, the Spielberger’s State-Trait Anxiety Inventory, the Beck Depression Inventory, the Perceived Social Support Scale, the Toronto Alexithymia Scale and the Personal Reaction Inventory. Results. A DSM-IV Axis I diagnosis was found in nine patients (41%); four patients (18%) presented with an Axis II diagnosis. One month after OHT, scores of depression, anxiety and general health significantly improved, while scores of social support, alexithymia and social desirability did not differ. In the sixth postoperative month, all psychological scores remained stable. Conclusions. A high prevalence of preoperative psychopathology was reported in 22 candidates who received OHT. Surgical intervention obviously improved the quality of life after cardiac transplantation. If the impact of psychological and/or psychiatric aid remains difficult to appraise, these results emphasize the positive impact of surgery on psychological status and the appropriateness of the psychosomatician’s social support intervention on patients facing the transplant process.

Keywords

alexithymiaanxietydepressiongeneral healthheart transplantationsocial desirabilitysocial support
Type
Original article
Information
European Psychiatry , Volume 16 , Issue 3 , April 2001 , pp. 180 - 185
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Almon, P., Mikhail, G., Stanford, S.C., Zielinsk, S., Pepper, J.R.Psychological adjustment after cardiac transplantation. J Psychosom Res 1998; 45: 449-458.CrossRefGoogle Scholar
Barsky, A.J., Aheren, D.K., Brener, J., Surman, O.S., Ring, C., Dec, G.W.Palpitations and cardiac awareness heart transplantation. Psychosom M 1998; 60: 557-562.CrossRefGoogle ScholarPubMed
Beck, A., Rial, W., Rickels, K.Short form of depression inventory: cross validation. Psychol Rep 1974; 34: 1184-1186.Google ScholarPubMed
Blumenthal, J.A., Burg, M.M., Barefoot, J., Williams, R.B., Haney, T., Zimet, G.Social support, type A behavior and coronary aArtery disease. Psychosoma M 1987; 49: 331-340.CrossRefGoogle ScholarPubMed
Bunzel, B., Laederach-Hofmann, K., Schubert, M.T.Patients benefit–partners suffer? The impact of heart transplantation on the partner relationship. Transpl Int 1992; 12: 33-41.Google Scholar
Caine, N., Sharples, L.D., Dennis, C., Higenbottam, T.W., Wallwork, J.Measurement of health-related quality of life before and after heart-lung transplantation. J Heart Lung Transplant 1996; 15: 1047-1057.Google ScholarPubMed
Cupples, S.A., Nolan, M.T., Augustine, S.M., Kynoch, D.Perceveid stressors and coping strategies among heart transplant candidates. J Transpl Coord 1998; 8: 179-187.CrossRefGoogle ScholarPubMed
Dew, M.A., Simmons, R.G., Roth, L.H., Schulberg, H.C., Thompson, M.E., Armitage, J.M., Griffith, B.P.Psychological predictors of vulnerability to distress in the year following heart transplatation. Psychol M 1994; 24: 929-945.CrossRefGoogle Scholar
Fisher, D.C., Lake, K.D., Reutzel, T.J., Emery, R.W.Changes in health-related quality of life and depression in heart transplant recipients. J.Heart Lung Transplant 1995; 14: 373-381.Google ScholarPubMed
Garrity, T.F., Klein, R.F.Emotional response and clinical severity as early determinants of six-month mortality after myocardial infarction. Heart Lung 1975; 4: 730-737.Google ScholarPubMed
Golberg, D.P., Hillier, V.F.A scaled version of the general health questionnaire. Psychol M 1979; 9: 139-145.CrossRefGoogle Scholar
Grady, K.L., Jalowiec, A., White-Williams, C.Improvement in quality of life in patients with heart failure who undergo transplantation. J Heart Lung Transplant 1996; 15: 749-757.Google ScholarPubMed
Grady, K.L., Jalowiec, A., White-Williams, C.Quality of life 6 months after heart transplantation compared with Indicators of illness severity before transplantation. Am J Crit Care 1998; 7: 106-116.CrossRefGoogle ScholarPubMed
Hecker, J.E., Norvell, N., Hills, H.Psychologic assessment of candidates for heart transplantation: toward a normative data base. J Heart Transplant 1989; 8: 171-176.Google Scholar
Hetzer, R., Albert, W., Hummel, M., Pasic, M., Loebe, M., Warnecke, H.et alStatus of patients presently living 9 to 13 years after orthoptic heart transplantation. Ann Thorac Surg 1997; 64: 1661-1668.CrossRefGoogle Scholar
Kaba, E., Shanley, E.Identification of coping strategies used by heart transplant recipients. Br J Nurs 1997; 6: 858-862.CrossRefGoogle ScholarPubMed
Kimball, C.P.Psychological responses to the experience of open heart surgery. Moos, R.HCoping with physical illness New York: Plenum; 1977. p. 113-133Google Scholar
Kuhn, W.F., Myers, B., Brennan, A.F., Davis, M.H., Lippman, S.B., Gray, L.A.et alPsychopathology in heart transplant candidates. J Heart Transplant 1988; 7: 223-226.Google ScholarPubMed
Leon, E, Baudin, ML, Consoli, SM. Aspects psychiatriques des greffes d’organes. Encycl Méd Chir (Elsevir, Paris) 37670 A-65, 11. 1990: 6 p.Google Scholar
Littlefield, C., Abbey, S., Fiducia, D., Cardella, C., Greig, P., Levy, G.et alQuality of life following transplantation of the heart, liver, and lungs. Gen Hosp Psychiatry 1996; 18 Suppl 6: 36S-47S.CrossRefGoogle Scholar
Loas, G., Otmani, O., Fremaux, D., Lecercle, C., Duflot, M., Delahousse, J.Etude de la validité externe, de la fidèlité et détermination des notes seuils des échelles d’alexithymie de Toronto (TAS Et TAS-20) Chez un groupe de patients alcooliques. Encéphale 1996; XXII: 35-40.Google Scholar
Mumford, E., Schlesinger, H.J., Glass, G.V.The effects of psychological intervention on recovery from surgery and heart attacks: an analysis of literature. Am J Public Health 1982; 72: 141-151.CrossRefGoogle Scholar
Paris, W., Brawner, N., Thompson, S., Penido, M.Psychological issues in heart transplantation: a review for transplant coordinators. J Transpl Coord 1997; 7: 88-93.CrossRefGoogle ScholarPubMed
Reynolds, W.M.Development of reliable and valid short forms of the Marlowe-Crowne Social Desirability Scale. J Clin Psychol 1982; 38: 119-125.3.0.CO;2-I>CrossRefGoogle Scholar
Riedmayr, M.I., Tammen, A.R., Behr, T.M., Witting, C., Bullinger, M., Reichart, B.et alPerspectives of patients with terminal renal failure: quality of life and psychological adjustment before and in the first year after heart transplantation. Z Kardiol 1998; 87: 808-816.CrossRefGoogle ScholarPubMed
Roman, D.D., Kubo, S.H., Ormaza, S., Francis, G.S., Bank, A.J., Shumway, S.J.Memory improvement following cardiac transplantation. J Clin Exp Neuropsychol 1997; 19: 692-697.CrossRefGoogle ScholarPubMed
Skotzo, C.E., Rudis, R., Kobashigawa, J.A., Laks, H.Psychiatric disorders and outcome following cardiac transplantation. J Heart Lung Transplant 1999; 18: 952-956.CrossRefGoogle Scholar
Spielberger, C.D.Manual for the State-Trait Anxiety Inventory (form Y) (‘Self-evaluation questionnaire’) Palo Alto, CA: Consulting Psychologists Press; 1983.Google Scholar
Taylor, G.J., Bagby, R.M., Parker, J.D.A.The Revised Toronto Alexithymia Scale: some reliability, validity and normative data. Psychother Psychosom 1992; 57: 34-41.CrossRefGoogle ScholarPubMed
Zipfel, S., Lowe, B., Paschke, T., Immel, B., Lange, R., Zimmermann, R.et alPsychological distress in patients awaiting heart transplantation. J Psychosom Res 1998; 45: 465-470.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.