title: The importance of mental health monitoring during transfer to adult care settings as examined among paediatric transplant recipients.
abstract: OBJECTIVE
  Although the transfer out of paediatrics is established as a dangerous time for transplant recipients, the reasons for this are not well understood. One possible explanation is that in general, young adulthood is a period of vulnerability to psychological distress, which could impact self-management. The purpose of the present study was to investigate whether psychological distress is associated with medication non-adherence after transfer.
  
  
  METHODS
  Twenty paediatric liver transplant recipients (mean age = 22.42, standard deviation (SD) = 1.64) have been followed prospectively at our site for a year after they transferred from paediatrics. At their last visit in paediatrics, they completed the Symptom Checklist-90, a measure of psychological distress. Additionally, patients' medication adherence was tracked 1 year after transfer, using a validated measure, SDs of tacrolimus blood levels.
  
  
  RESULTS
  Psychological distress and medication non-adherence after transfer were significantly correlated, r = 0.50, P = 0.04. Furthermore, there was a significant interaction between adherence status and changes in mental health after transfer.
  
  
  CONCLUSIONS
  Psychological distress may be one factor behind deteriorating medical outcomes when transplant recipients transfer out of paediatric settings. It is important to consider mental health screening as a part of the transition process. Further research is needed to determine if identified patients may require services in addition to transitional interventions.
authors.affiliation: Department of Psychology, Fordham University, Bronx, New York, United States; Department of Pediatrics, Kravis Children's Hospital & Recanati/Miller Transplant Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States.
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Annunziato
authors.forename: Nicole
authors.initials: N
authors.lastname: Arrato
authors.forename: Melissa
authors.initials: M
authors.lastname: Rubes
authors.forename: Ronen
authors.initials: R
authors.lastname: Arnon
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008603:Mental Health; D010372:Pediatrics; D012646:Self Administration; D012648:Self Care / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology*; D066027:Transplant Recipients / Q000523:psychology*; D055815:Young Adult
keywords: adherence; mental health; transfer; transition