Psychosocial assessment of living kidney donors: What implications have temperament and character for decision-making?
OBJECTIVE
We compared the personality of kidney donor candidates to non-donor controls and analyzed the personality profile of candidates psychosocially at risk.


METHODS
49 consecutive living kidney donor candidates underwent an extensive psychosocial evaluation. Psychosocial risk factors concerning knowledge of donation risks (1), donor-recipient-relationship (2), and/or mental health (3) were rated on a 3-point rating scale (0=high risk, 2=no risk). Furthermore, candidates as well as 49 age-and gender-matched non-donor controls filled in questionnaires concerning psychological distress (Symptom Checklist 90-R) and personality (Temperament and Character Inventory).


RESULTS
There were no significant differences between candidates and controls concerning psychological distress or personality. Psychosocial assessment identified 13 candidates (26.5%) with increased psychosocial risk. This group displayed compared to candidates without psychosocial risk no difference concerning age, gender, formal education, donor-recipient relationship and psychological distress. However, this group scored significantly higher on reward dependence compared to suitable donors and controls (p<0.05). Reward dependence was associated with a lack of adequate knowledge on donation (r=-0.35, p<0.05).


CONCLUSIONS
Reward dependence has important implications for decision-making, because it is associated with an increased tendency to deny potential risks of donation. Careful identification and assessment of reward dependent donor candidates is needed to ensure a free-willed decision.
Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Bonn, Germany. Electronic address: Rupert.Conrad@ukb.uni-bonn.de.
Rupert
R
Conrad
Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Bonn, Germany.
Alexandra
A
Kleiman
Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Bonn, Germany.
Stefanie
S
Rambau
Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Bonn, Germany.
Ingo
I
Wegener
Department of General Practice and Family Medicine, University of Bonn, Bonn, Germany; Department of Palliative Medicine, University of Bonn, Bonn, Germany.
Martin
M
Mücke
Department of Clinical Chemistry and Clinical Pharmacology, University of Bonn, Bonn, Germany.
Ramona Christina
RC
Dolscheid-Pommerich
Department of Clinical Chemistry and Clinical Pharmacology, University of Bonn, Bonn, Germany.
Berndt
B
Zur
Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Bonn, Germany.
Franziska
F
Geiser
D000328:Adult; D016022:Case-Control Studies; D002605:Character; D003657:Decision Making; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000523:psychology*; D019520:Living Donors / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000523:psychology*; D010551:Personality; D010552:Personality Assessment; D010555:Personality Inventory / Q000706:statistics & numerical data; D011581:Psychological Tests; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013694:Temperament