title: MELDNa score is associated with psychopathology and reduced quality of life in cirrhotic patients with a liver transplant perspective.
abstract: Psychopathological symptoms and reduced health related quality of life (HRQoL) are frequent in cirrhotics, but no data on their association with cirrhosis prognosis assessed by the MELDNa score are available. Prospective data on the long-term effect of deceased donor liver transplantation (LT) on psychopathological symptoms are needed. Before entering the LT waiting list, 44 consecutive LT cirrhotic candidates without a major psychiatric disorder underwent a psychopathological assessment, including Symptom Checklist-90-revised (SCL-90-R) and Defense Style Questionnaire (DSQ). HRQoL was measured by Short Form 36 Health Survey (SF-36). Abnormal performance at each questionnaire was defined by using 44 age, gender, BMI and education-matched healthy subjects. Separate binary logistic regression models were used to test the association of the Child-Pugh, MELD and MELDNa scores with abnormal performance at each questionnaire. Fourteen patients repeated the battery tests 3 years after LT. Before LT, increasing MELDNa was the only prognostic score independently associated with an abnormal SCL-90-R global psychopathological score index (OR: 1.207; 95% CI: 1.026-1.420; P = 0.02) and the best independent predictor of reduced HRQoL. After LT, compared to status prior to LT, performance at SF-36 general health perception scale ameliorated (P = 0.02), performance at SCL-90-R somatization scale (P = 0.001) and global psychopathological score index (P < 0.001) worsened and the negative correlation between the psychopathological global score index and HRQoL disappeared. The severity of cirrhosis in LT candidates should be monitored by the MELDNa score to better establish the right psychological counselling. Psychopathology, and in particular somatization, worsens after LT and should be carefully investigated.
authors.affiliation: Department of Neurology and Psychiatry, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Cavaggioni
authors.affiliation: Department of Clinical Medicine, Division of Gastroenterology, "Sapienza" University of Rome, Viale dell' Università 37, 00185, Rome, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Poli
authors.affiliation: Department of Clinical Medicine, Division of Gastroenterology, "Sapienza" University of Rome, Viale dell' Università 37, 00185, Rome, Italy.
authors.forename: Flaminia
authors.initials: F
authors.lastname: Ferri
authors.affiliation: Department of Clinical Medicine, Division of Gastroenterology, "Sapienza" University of Rome, Viale dell' Università 37, 00185, Rome, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Parlati
authors.affiliation: Department of Neurology and Psychiatry, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Monaco
authors.affiliation: Department of Neurology and Psychiatry, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Melcore
authors.affiliation: Department of Clinical Medicine, Division of Gastroenterology, "Sapienza" University of Rome, Viale dell' Università 37, 00185, Rome, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Lattanzi
authors.affiliation: Department of Clinical Medicine, Division of Gastroenterology, "Sapienza" University of Rome, Viale dell' Università 37, 00185, Rome, Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Merli
authors.affiliation: Department of General Surgery "Paride Stefanini" "Sapienza" University of Rome, Rome, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Mennini
authors.affiliation: Department of General Surgery "Paride Stefanini" "Sapienza" University of Rome, Rome, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Melandro
authors.affiliation: Department of General Surgery "Paride Stefanini" "Sapienza" University of Rome, Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Rossi
authors.affiliation: Department of Clinical Medicine, Division of Gastroenterology, "Sapienza" University of Rome, Viale dell' Università 37, 00185, Rome, Italy. stefano.corradini@uniroma1.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Ginanni Corradini
mesh_terms: D058625:End Stage Liver Disease / Q000175:diagnosis / Q000523:psychology / Q000601:surgery; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000523:psychology* / Q000601:surgery*; D016031:Liver Transplantation / Q000523:psychology* / Q000639:trends; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: Cirrhosis; Liver transplantation; MELDNa; Psychopathology; Quality of life