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Posttraumatic Stress Disorder in Posttransplant Children: Creating a Clinical Program to Address Their Needs

Published online by Cambridge University Press:  07 November 2014

Sukru Emre
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Abstract

Posttraumatic stress symptoms have been shown to occur in pediatric and adult solid-organ transplant recipients. The presence of these symptoms is associated with non-adherence to medications, increased distress, and poor outcome. Because posttraumatic stress disorder is treatable and because a transplant operation usually is an “anticipated trauma,” it is possible to address posttraumatic stress disorder symptoms in transplant recipients and attempt to prevent their development. Under my direction, the pediatric liver transplant program at Mount Sinai Medical Center in NewYork City created research and clinical programs to address posttraumatic stress symptoms and their consequences. Specifically, the focus on non-adherence to immunosuppressive medications in transplant recipients who are distressed and their parents. This article begins with a review of the data that led to the decision to start these programs. I then present the basic elements that are in place, in this particular program, to address patients' needs. I end this review with preliminary outcome data that illustrate the potential impact of such an integrated approach to patient care on medical outcomes.

Type
Review Articles
Information
CNS Spectrums , Volume 11 , Issue 2 , February 2006 , pp. 118 - 126
Copyright
Copyright © Cambridge University Press 2006

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References

REFERENCES

1.United Network for Organ Sharing Web site. Available at: http://www.unos.org. Accessed 09 2, 2005.Google Scholar
2.Olbrisch, ME, Levenson, JL. Psychosocial assessment of organ transplant candidates. Current status of methodological and philosophical issues. Psychosomatics. 1995;36:236–243.Google Scholar
3.Levenson, JL, Olbrisch, ME. Psychosocial evaluation of organ transplant candidates. A comparative survey of process, criteria, and outcomes in heart, liver, and kidney transplantation. Psychosomatics. 1993;34:314–323.CrossRefGoogle ScholarPubMed
4.Skotzko, CE, Stowe, JA, Wright, C, Kendall, K, Dew, MA. Approaching a consensus: psychosocial support services for solid organ transplantation programs. Prog Transplant. 2001;11:163–168.Google Scholar
5.Dew, MA, Switzer, GE, DiMartini, AF, Matukaitis, J, Fitzgerald, MG, Kormos, RL. Psychosocial assessments and outcomes in organ transplantation. Prog Transplant. 2000;10:239–259.Google Scholar
6.Olbrisch, ME, Benedict, SM, Ashe, K, Levenson, JL. Psychological assessment and care of organ transplant patients. J Consult Clin Psychol. 2002;70:771–783.CrossRefGoogle ScholarPubMed
7.EBPG (European Expert Group on Renal Transplantation): European Renal Association (ERA-EDTA): European Society for Organ Transplantation (ESOT). European Best Practice Guidelines for Renal Transplantation (part 1). Nephrol Dial Transplant. 2000;15(suppl 7):1–85.Google Scholar
8.Engle, D. Psychosocial aspects of the organ transplant experience: what has been established and what we need for the future. J Clin Psychol. 2001;57:521–549.Google Scholar
9.Lurie, S, Shemesh, E, Sheiner, PA, et al.Non-adherence in pediatric liver transplant recipients—an assessment of risk factors and natural history. Pediatr Transplant. 2000;4:200–206.Google Scholar
10.Shemesh, E, Lurie, S, Stuber, ML, et al.A pilot study of post traumatic stress and nonadherence in pediatric liver transplant recipients. Pediatrics. 2000;105:e29.Google Scholar
11.Walker, AM, Harris, G, Baker, A, Kelly, D, Houghton, J. Post-traumatic stress responses following liver transplantation in older children. J Child Psychol Psychiatry. 1999;40:363–374.Google Scholar
12.Young, GS, Mintzer, LL, Seacord, D, Castaneda, M, Mesrkhani, V, Stuber, ML. Symptoms of posttraumatic stress disorder in parents of transplant recipients: incidence, severity, and related factors. Pediatrics. 2003;111(6 pt 1):e725–e731.Google Scholar
13.Stukas, AA Jr, Dew, MA, Switzer, GE, DiMartini, A, Kormos, RL, Griffith, BP. PTSD in heart transplant recipients and their primary family caregivers. Psychosomatics. 1999;40:212–221.Google Scholar
14.Dew, MA, Kormos, RL, Roth, LH, Murali, S, DiMartini, A, Griffith, BP. Early posttransplant medical compliance and mental health predict physical morbidity and mortality one to three years after heart transplantation. J Heart Lung Transplant. 1999;18:549–562.Google Scholar
15.Shemesh, E. Non-adherence to medications following pediatric liver transplantation. Pediatr Transplant. 2004;8:600–605.Google Scholar
16.Shemesh, E, Newcorn, JH, Rockmore, L, et al.Comparison of parent and child reports of emotional trauma symptoms in pediatric outpatient settings. Pediatrics. 2005;115:e582–e589.Google Scholar
17.Shemesh, E, Annunziato, RA, Shneider, BL, et al.Parents and clinicians underestimate distress and depression in children who had a transplant. Pediatr Transplant. 2005;9:673–679.Google Scholar
18.Shemesh, E, Annunziato, RA, Newcorn, JH, et al.Assessment Of posttraumatic stress symptoms in children who are medically ill and children presenting to a child trauma program. Ann N Y Acad Sci. In press.Google Scholar
19.Shemesh, E, Stuber, ML. Posttraumatic stress disorder: what is known, what needs to be determined, and why is it important? CNS Spectr. 2006;11:106–117.Google Scholar
20.Oakley, C, Moore, D, Burford, D, Fahrenwald, R, Woodward, K. The Montana model: integrated primary care and behavioral health in a family practice residency program. J Rural Health. 2005;21:351–354.Google Scholar
21.Pincus, HA, Houtsinger, JK, Bachman, J, Keyser, D. Depression in primary care: bringing behavioral health care into the mainstream. Health Aff (Millwood). 2005;24:271–276.Google Scholar
22.Gallo, JJ, Zubritsky, C, Maxwell, J, et al.Primary care clinicians evaluate integrated and referral models of behavioral health care for older adults: results from a multisite effectiveness trial (PRISM-e). Ann Fam Med. 2004;2:305–309.Google Scholar
23.Orleans, CT. Addressing multiple behavioral health risks in primary care. Broadening the focus of health behavior change research and practice. Am J Prev Med. 2004;27(2 suppl):1–3.Google Scholar
24.Satterfield, JM, Mitteness, LS, Tervalon, M, Adler, N. Integrating the social and behavioral sciences in an undergraduate medical curriculum: the UCSF essential core. Acad Med. 2004;79:6–15.Google Scholar
25.Gallagher, RM. Treatment planning in pain medicine. Integrating medical, physical, and behavioral therapies. Med Clin North Am. 1999;83:823–849.Google Scholar
26.Purcell, DW, Metsch, LR, Latka, M, et al.Interventions for seropositive injectors-research and evaluation: an integrated behavioral intervention with HIV-positive injection drug users to address medical care, adherence, and risk reduction. J Acquir Immune Defic Syndr. 2004 10 1:37(suppl 2):S110–S118.Google Scholar
27.Shemesh, E, Yehuda, R, Rockmore, L, et al.Assessment of depression in medically ill children presenting to pediatric specialty clinics. J Am Acad Child Adolesc Psychiatry. 2005;44:1249–1257.Google Scholar
28.Sheeran, T, Zimmerman, M. Screening for posttraumatic stress disorder in a general psychiatric outpatient setting. J Consult Clin Psychol. 2002;70:961–966.Google Scholar
29.Rodriguez, N, Steinberg, A, Pynoos, RS. UCLA Post Traumatic Stress Disorder Reaction Index for DSM-IV, Child, Adolescent, and Parent Versions; 1998 (available from the authors)Google Scholar
30.Ambrosini, PJ. Historical development and present status of the schedule for affective disorders and schizophrenia for school-age children (K-SADS). J Am Acad Child Adolesc Psychiatry. 2000;39:49–58.Google Scholar
31.Shemesh, E, Shneider, BL, Warshaw, J, et al. Improving adherence to medications in pediatric liver transplant recipients. Abstract presented at: Annual Meeting of the American Society of Transplant Surgeons: January 19-22, 2006, Scottsdale, Ariz.Google Scholar
32.Shemesh, E, Shneider, BL, Savitzky, JK, et al.Medication adherence in pediatric and adolescent liver transplant recipients. Pediatrics. 2004;113:825–832.Google Scholar