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Psychological evolution and assessment in patients undergoing orthotopic heart transplantation

Published online by Cambridge University Press:  16 April 2020

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: francoise.tassin@chu.ulg.ac.be (J.M. Triffaux).
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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.

Type
Original article
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2001

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