title: Posttraumatic stress disorder after liver transplantation.
abstract: BACKGROUND
  Liver transplantation can lead to the development of posttraumatic stress disorder (PTSD), but the risk factors associated with this progression are not well understood. To study this syndrome in adult liver transplant recipients, a cross-sectional investigation of 296 recipients at our hospital was carried out between January and June 2010.
  
  
  METHODS
  Study participants completed two questionnaires [a PTSD self-rating scale (PTSD-SS) and a validated Chinese version of the Medical Outcomes Study Short Form-36 (SF-36)]. Clinical and demographic data were collected from the records of the Chinese Liver Transplant Registry and via questionnaires.
  
  
  RESULTS
  The prevalence of full PTSD and partial PTSD (that met the criteria for 2 of the 3 symptom clusters) was 3.7% and 5.4%, respectively, for all transplant recipients. Significant differences between the recipients with no PTSD, partial PTSD, and full PTSD were found in all SF-36 domains except for physical functioning (P=0.466). In general, domain scores were the highest in the recipients who did not meet the criteria for PTSD and the lowest in the recipients who met the criteria for full PTSD. Greater severity of posttraumatic stress symptoms was correlated with poorer quality of life, especially in the bodily pain (P=0.004), social functioning (P=0.001), role-emotional (P=0.048), and mental health (P<0.001) domains. The model for end-stage liver disease (MELD) scores, complications, and educational status were identified by multiple regression analysis as risk factors for developing PTSD.
  
  
  CONCLUSIONS
  PTSD occurred after liver transplantation and was significantly associated with decreased quality of life. Higher MELD scores and complications after transplantation were risk factors that contributed to PTSD, and higher education was a protective factor.
authors.affiliation: Department of Liver and Vascular Surgery, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Shu-Guang
authors.initials: SG
authors.lastname: Jin
authors.forename: Lu-Nan
authors.initials: LN
authors.lastname: Yan
authors.forename: Bo
authors.initials: B
authors.lastname: Xiang
authors.forename: Bo
authors.initials: B
authors.lastname: Li
authors.forename: Tian-Fu
authors.initials: TF
authors.lastname: Wen
authors.forename: Ji-Chun
authors.initials: JC
authors.lastname: Zhao
authors.forename: Ming-Qing
authors.initials: MQ
authors.lastname: Xu
authors.forename: Jia-Ying
authors.initials: JY
authors.lastname: Yang
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D002681:China; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome