Prevalence of psychiatric disorders and suicidal ideation in liver transplanted patients: a cross-sectional study.
OBJECTIVE
Liver transplantation is the first choice treatment for terminal liver disease, but its success is strictly related to the adherence to immunosuppressive therapy. Psychiatric disorders can decrease both adherence and quality of life of liver transplanted patients. We aimed to assess prevalence of post-transplant psychiatric disorders in liver transplanted patients and its association with quality of life, adherence, suicidal ideation.


METHODS
Psychiatric examination was performed with an internationally validated structured clinical interview: Mini International Neuropsychiatric Interview Plus. Quality of life was assessed using The Short Form (36) Health Survey (SF36). Adherence was established by the Siegal scale, a 7-point self-reported scale, and by collateral reports of relatives and transplant clinicians. The Scale for Suicide Ideation (SSI) was used for suicidal risk assessment.


RESULTS
Fifty-one liver transplanted patients (mean age: 60.06 years, SD: 6.49) were enrolled. Thirty patients (58.82%) suffered from one or more psychiatric disease. Patients diagnosed with psychiatric disease displayed worse scores at SSI (P=0.032) and at several SF36 items: physical health (P=0.038), vitality (P=0.012), social activities (P=0.027), emotional state (P=0.031), mental health (P=0.014). Both patients with major depression and patients with two or more psychiatric disorders displayed lower adherence (P≤0.001 and P=0.002). Diagnosis of major depression was associated with female sex (P=0.021), aggressiveness (P=0.042), chronic rejection (P=0.011).


CONCLUSIONS
We confirm the high prevalence of psychiatric disease in our cohort of liver transplanted patients. The presence of psychiatric disease is associated with decreased quality of life and increased suicide ideation. Patients with major depression should be considered significantly at risk for non-adherence.
Section of psychotherapy, Department of Neurological Sciences, "Federico II" University, Via Pansini 5, 80131 Napoli, Italy. Electronic address: luca.errichiello@gmail.com.
Luca
L
Errichiello
Section of psychotherapy, Department of Neurological Sciences, "Federico II" University, Via Pansini 5, 80131 Napoli, Italy. Electronic address: dmpicozzi@alice.it.
Domenico
D
Picozzi
Section of psychotherapy, Department of Neurological Sciences, "Federico II" University, Via Pansini 5, 80131 Napoli, Italy. Electronic address: enricodenotaris@gmail.com.
Enrico Beniamino
EB
de Notaris
D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000523:psychology*; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology*; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000523:psychology*; D015995:Prevalence; D059020:Suicidal Ideation