There is a lot of evidence about the importance of the psychiatric evaluation of liver transplant candidates, particularly the ones with history of alcoholism.
We studied 53 sequential liver transplantation candidates of a Liver Transplantation Unit integrated in a Public General Hospital (20,7% Paramiloidosis, 16,9% Alcoholic Cirrhosis, 11,2% Hepatitis C, 3,7% Liver Cancer, 47,7% other diagnosis and mixed diagnosis).
We aimed to study the psychiatric profile of this population by means of a psychiatric interview, DSM-IV diagnosis, TAS (Taylor 1991), Neo FFI (Costa 1992), HADS (Zigmond 1963), PACT (Olbrisch 1989) and HRARS (Booth, 1993).
Out of our patients (70% males, 56% married, 32% active), 18,9% had had at least one episode of depression, 3,8% an anxiety disorder, 5,7% alcohol abuse disorder, 17% alcohol dependence disorder, 3,6% dependence or abuse of other substances and 24,6% mixed psychiatric diagnosis.
The actual psychiatric diagnosis was in 26,4% Major Depressive Disorder, 20,8% Generalized Anxiety Disorder, 5,7% adaptive disorder, 1,9% dependence/abuse of other substances than alcohol, 1,9% dementia, and 3,7% mixed diagnostics.
We found that 17% were alexithymic, 28% had moderate-high scores for HADS-anxiety, and 14% for HADS-depression. The mean score for neuroticism, extraversion, and conscientiousness was high for this population, the social suport was good in 62,3% and within the alcohol group, the risk of alcohol relapse was moderated in 42,1% and high in 36,8%.
There were significant differences in psychiatric profile for the Alcohol and Paramiloidosis groups showing they require specific strategies of psychiatric aproach.