PSYCHOSOCIAL MORBIDITY IN BONE-MARROW TRANSPLANT RECIPIENTS - A PROSPECTIVE-STUDY

Previous work has demonstrated that psychosocial morbidity may occur f ollowing bone marrow transplantation (BMT), but few prospective quanti tative data are available, especially in adults. We have conducted a p rospective psychological assessment of 36 patients accepted onto our B MT programme, of whom 31 proceeded to transplant. Patients were assess ed shortly before admission for BMT and again at about 4 and 8 months after the procedure, using the following tools: Hospital Anxiety and D epression Scale (HAD), Social Adjustment Scale-Self Report and the Pre sent State Examination (PSE). A 54% incidence of psychosocial morbidit y (as assessed by either an abnormal HAD or PSE result) was found amon g those cases assessed both before and at least once after BMT. Signif icant psychosocial morbidity was still present 6-9 months following BM T. Cases scoring abnormally following BMT in general also scored abnor mally before transplant, suggesting a predictive value of pre-BMT psyc hological assessment. Psychological morbidity was unrelated to the typ e of transplant. Patients with chronic myeloid leukaemia had a higher incidence of post-BMT psychosocial morbidity than patients with other diagnoses; it is suggested that this may be due to their lack of previ ous experience of intensive haematological therapy. Psychological eval uation may help in identifying patients at risk of post-BMT psychosoci al problems.