Heart or heart-lung transplantation: psychosocial outcome.
The psychosocial outcome of 23 heart and 21 heart-lung transplant recipients, aged 5-17 yrs, was determined and compared with the psychosocial outcome of a group of 46 children and adolescents who underwent conventional cardiac surgery. Preoperatively, and 12 months post-operatively, the patients' physical health status, mental state (ICD-9) and level of psychosocial functioning (GAF scale, DSM-IIIR) were assessed. There was an improvement in physical health in all groups. Preoperatively, psychiatric disorder, including anxiety and phobic states, depression and adjustment reaction, was noted in 6/23 (26%) children assessed for heart transplantation, 6/21 (28.5%) children assessed for heart-lung transplantation, and 12/46 (26%) children undergoing conventional cardiac surgery. The prevalence of psychiatric disorder remained in the transplant group but decreased in the non-transplant comparison group (6.5%). Improvement in overall levels of psychosocial functioning were found in all groups, but over 40% of all the participants were still functioning below normal levels. In summary, children with end-stage cardio-respiratory disease benefit physically and psychologically from heart or heart-lung transplantation treatment but there is a need for systematic psychosocial support both before and after transplantation.
Serrano-Ikkos
E
E
Department of Psychological Medicine, Great Ormond Street Hospital, London, UK.
Lask
B
B
Whitehead
B
B
Rees
P
P
Graham
P
P
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006304:Health Status; D006333:Heart Failure / Q000601:surgery; D016027:Heart Transplantation / Q000523:psychology; D016041:Heart-Lung Transplantation / Q000523:psychology*; D006801:Humans; D015994:Incidence; D008297:Male; D008609:Mental Status Schedule; D015995:Prevalence; D011379:Prognosis; D011581:Psychological Tests; D011618:Psychotic Disorders / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology; D012131:Respiratory Insufficiency / Q000601:surgery; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology