title: Preoperative psychological factors predicting graft rejection in patients undergoing kidney transplant: a pilot study.
abstract: BACKGROUND
  The aim of this study was to investigate whether pretransplant psychological variables included in the CBA 2.0 Primary Scale-fear, personality, obsessive-compulsive symptoms, state and trait anxiety, psychological reactions, and depression-could predict graft rejection among patients undergoing kidney transplantation.
  
  
  METHODS
  After ethical committee approval we enrolled 33 consecutive adult patients undergoing kidney transplantation. The inclusion criteria were a stable clinical situation in an out-of-hospital setting; Italian language literacy; a minimum of secondary school-level education, and written informed consent. We excluded patients with a psychotic disturbance, neurocognitive deficit, dementia, serious mental delay (IQ <50), current alcohol or drug abuse, recent ideation or attempted suicide or nonadherence to the therapeutic protocol. Acute and/or chronic graft rejection was diagnosed according to clinical and histopathologic criteria. CBA-2,0 "Primary Scale" series of questionnaires were handed out to patients at the time of the examinations to discrem eligibility for transplantation. Analyses of variance were performed to compare psychological scores among patients with versus without graft rejection. Logistic regression analyses of psychological variables were performed to detect possible predictors for graft rejection. The results of the analysis showed that higher psychoticism scores were able to predict graft rejection (P<.05).
  
  
  RESULTS
  The findings of this study suggest that it is mandatory to preoperatively plan an holistic treatment including psychological intervention mainly focused on psychoticism.
authors.affiliation: Department of Psychiatry and Psychology, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Calia
authors.forename: C
authors.initials: C
authors.lastname: Lai
authors.forename: P
authors.initials: P
authors.lastname: Aceto
authors.forename: M
authors.initials: M
authors.lastname: Luciani
authors.forename: C
authors.initials: C
authors.lastname: Saraceni
authors.forename: S
authors.initials: S
authors.lastname: Lai
authors.forename: A
authors.initials: A
authors.lastname: Gargiulo
authors.forename: F
authors.initials: F
authors.lastname: Citterio
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D005260:Female; D006084:Graft Rejection / Q000276:immunology / Q000523:psychology*; D006801:Humans; D007558:Italy; D007676:Kidney Failure, Chronic / Q000523:psychology / Q000601:surgery*; D016030:Kidney Transplantation / Q000276:immunology / Q000523:psychology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome