Traumatic stress symptoms in adolescent organ transplant recipients.
OBJECTIVE
Symptoms of posttraumatic stress disorder (PTSD) after life-threatening medical illness have been found to predict poor outcome in preliminary studies of adults and children. However, these symptoms are rarely recognized in general medical or pediatric settings. Here we report on the first large investigation to assess prevalence and correlates of self-reported symptoms of posttraumatic stress in a nonreferred sample of adolescent liver, heart, and kidney transplant recipients.


METHODS
One hundred four adolescents, ages 12 to 20 years (mean: 15.7; SD: 2.1), completed and returned the University of California, Los Angeles, PTSD Index for the Diagnostic and Statistical Manual of Mental Disorders. All participants were at least 1 year post-initial transplant and were fluent speakers of English and/or Spanish.


RESULTS
More than 16% of the adolescents met all symptom criteria for PTSD, and an additional 14.4% met 2 of 3 symptom-cluster criteria. Regression analysis indicated no effect of gender, ethnicity, age at interview, organ type, time since transplant, or age at transplant.


CONCLUSIONS
As has been found with other life-threatening pediatric conditions, solid organ transplantation can precipitate symptoms of posttraumatic stress. Symptoms are not predicted by what would be considered objective factors increasing life threat, suggesting a greater salience of subjective appraisal of threat, as has been seen in studies of childhood cancer survivors.
Mintzer
Lisa Libman
LL
Division of Child and Adolescent Psychiatry, Department of Psychiatry and Biobehavioral Science, Neuropsychiatric Institute, University of California, Los Angeles, California, USA.
Stuber
Margaret L
ML
Seacord
Debra
D
Castaneda
Marleen
M
Mesrkhani
Violet
V
Glover
Dorie
D
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001293:Attitude to Death; D044383:Black People / Q000523:psychology; D002648:Child; D005260:Female; D016027:Heart Transplantation / Q000523:psychology*; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D016030:Kidney Transplantation / Q000523:psychology*; D016031:Liver Transplantation / Q000523:psychology*; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence; D012306:Risk; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000209:etiology*; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology*; D011795:Surveys and Questionnaires; D044465:White People / Q000523:psychology