title: Illness apprehension, depression, anxiety, and quality of life in liver transplant candidates: implications for psychosocial interventions.
abstract: BACKGROUND
  End-stage liver disease is associated with diminished quality of life (QOL). Numerous physical and psychosocial problems that affect QOL are common in those undergoing evaluation for liver transplantation.
  
  
  OBJECTIVE
  Identifying which of these challenges are most closely associated with QOL would be helpful in developing priority targets for evidence-based interventions specific to those undergoing transplant evaluation.
  
  
  METHODS
  A total of 108 adults undergoing psychologic assessment for liver transplant completed clinical interview, neuropsychologic testing, and self-report inventories of depression, anxiety, cognitive appraisal characteristics, support resources, and QOL.
  
  
  RESULTS
  Multiple regression analyses revealed that while emotional symptoms (anxiety and depression) were primarily associated with mental QOL, illness apprehension was the only variable uniquely associated with physical QOL after accounting for severity of liver disease, cognitive status, emotional symptoms, and support resources.
  
  
  CONCLUSIONS
  Findings suggest that psychosocial interventions prioritizing reduction of illness-related fear and symptoms of anxiety/depression would likely have the greatest effect on QOL in persons with end-stage liver disease awaiting transplantation.
authors.affiliation: Department of Gastroenterology, Hepatology, and Nutrition, Virginia Commonwealth University, Richmond, VA. Electronic address: Kstewart2@mcvh-vcu.edu.
authors.forename: Karen E
authors.initials: KE
authors.lastname: Stewart
authors.affiliation: Department of Psychiatry, Virginia Commonwealth University, Richmond, VA.
authors.forename: Robert P
authors.initials: RP
authors.lastname: Hart
authors.affiliation: Department of Psychiatry, Virginia Commonwealth University, Richmond, VA.
authors.forename: Douglas P
authors.initials: DP
authors.lastname: Gibson
authors.affiliation: Department of Surgery, Virginia Commonwealth University, Richmond, VA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Fisher
mesh_terms: D001007:Anxiety / Q000453:epidemiology / Q000209:etiology*; D003863:Depression / Q000453:epidemiology / Q000209:etiology*; D058625:End Stage Liver Disease / Q000150:complications / Q000523:psychology*; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D016031:Liver Transplantation / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology*