Psychological evolution and assessment in patients undergoing orthotopic heart transplantation

Background. Orthotopic heart transplantation (OHT) is a major surgical inte rvention inducing distress and anxiety. Psychiatric evaluation of organ tra nsplant candidates is now routinely proposed. This study purposed to assess the psychological evolution in patients having received psychological and/ or psychiatric assistance before and during 1-6 postoperative months. Metho ds. Twenty-two consecutive transplant candidates were psychically evaluated as part of the preoperative protocol. In the waiting period, 1 and 6 month s after OHT, they were asked to fill out the following questionnaires: the General Health Questionnaire, the Spielberger's State-Trait Anxiety Invento ry, the Beck Depression Inventory, the Perceived Social Support Scale, the Toronto Alexithymia Scale and the Personal Reaction Inventory. Results. A D SM-IV Axis I diagnosis was found in nine patients (41%); four patients (18% ) presented with an Axis II diagnosis. One month after OHT, scores of depre ssion, anxiety and general health significantly improved, while scores of s ocial support, alexithymia and social desirability did not differ. In the s ixth postoperative month, all psychological scores remained stable. Conclus ions. A high prevalence of preoperative psychopathology was reported in 22 candidates who received OHT. Surgical intervention obviously improved the q uality of life after cardiac transplantation. If the impact of psychologica l and/or psychiatric aid remains difficult to appraise, these results empha size the positive impact of surgery on psychological status and the appropr iateness of the psychosomatician's social support intervention on patients facing the transplant process. (C) 2001 Editions scientifiques et medicales Elsevier SAS.