title: A prospective cohort study on posttraumatic stress disorder in liver transplantation recipients before and after transplantation: Prevalence, symptom occurrence, and intrusive memories.
abstract: This study aimed at increasing the understanding of posttraumatic stress disorder (PTSD) in liver transplant patients by describing the course of PTSD, symptom occurrence, psychological co-morbidity, and the nature of re-experiencing symptoms.
  
  
  
  A prospective cohort study was performed among 95 liver transplant recipients from before transplantation up until one year post-transplantation. Respondents filled out a questionnaire regarding psychological functioning (PTSD, anxiety, and depression) before, and at 3, 6, and 12months post-transplantation. Both quantitative and qualitative methods were used to analyze the data.
  
  
  
  Before transplantation, respectively 10.5% and 6.3% of the respondents were identified as possible cases of full or partial PTSD. In all cases, co-morbid conditions of anxiety and/or depression were present. After transplantation, no new onset of full PTSD was found. New onset of possible partial PTSD was found in six respondents. Arousal symptoms were the most frequently reported symptoms, but may not be distinctive for PTSD in transplant patients because of the overlap with disease- and treatment-related symptoms. Re-experiencing symptoms before transplantation were mostly related to waiting for a donor organ and the upcoming surgery; after transplantation this was related to aspects of the hospital stay.
  
  
  
  In our group of liver transplant patients, PTSD symptomatology was more present before transplantation than after transplantation. Being diagnosed with a life-threatening disease seemed to be the main stressor. However, when a diagnosis of PTSD is suspected, assessment by a clinician is warranted because of the overlap with mood and anxiety disorders, and disease- and treatment-related symptoms.
authors.affiliation: University of Groningen, University Medical Center Groningen, School of Nursing & Health, Groningen, The Netherlands. Electronic address: j.h.annema@umcg.nl.
authors.forename: Coby
authors.initials: C
authors.lastname: Annema
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Gastroenterology and Hepatology, Groningen, The Netherlands.
authors.forename: Gerda
authors.initials: G
authors.lastname: Drent
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Health Psychology, Groningen, The Netherlands.
authors.forename: Petrie F
authors.initials: PF
authors.lastname: Roodbol
authors.affiliation: Erasmus Medical Center, Department of Gastroenterology and Hepatology, Rotterdam, The Netherlands.
authors.forename: Herold J
authors.initials: HJ
authors.lastname: Metselaar
authors.affiliation: Leiden University Medical Center, Department of Gastroenterology and Hepatology, Leiden, The Netherlands.
authors.forename: Bart
authors.initials: B
authors.lastname: Van Hoek
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Surgery, Section of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Groningen, The Netherlands.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Porte
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Health Psychology, Groningen, The Netherlands.
authors.forename: Maya J
authors.initials: MJ
authors.lastname: Schroevers
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Health Psychology, Groningen, The Netherlands.
authors.forename: Adelita V
authors.initials: AV
authors.lastname: Ranchor
mesh_terms: D000328:Adult; D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D015331:Cohort Studies; D015897:Comorbidity; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016031:Liver Transplantation / Q000523:psychology* / Q000639:trends; D008297:Male; D008568:Memory; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D011795:Surveys and Questionnaires; D013997:Time Factors; D066027:Transplant Recipients / Q000523:psychology*
keywords: Intrusive memories; Liver transplantation; PTSD; Psychological distress; Transplant candidates; Transplant recipients