Psychological evaluation after cardiac transplantation: The integration ofdifferent criteria

Background: The psychological evaluation of patients undergoing cardiac tra nsplantation is currently based on DSM-IV criteria. An alternative diagnost ic and conceptual framework has been proposed by an international group of psychosomatic investigators. The aim of this study was to compare these new criteria (Diagnostic Criteria for Psychosomatic Research, DCPR) with DSM-I V in a population where a high prevalence of psychological problems is expe cted (heart-transplanted patients). Method: 129 consecutive patients who un derwent heart transplant surgery were assessed according to DSM-IV and DCPR criteria. Results: The results showed a higher number of diagnoses made us ing the DCPR than with the use of the DSM-IV. At least one DCPR diagnosis w as found in 85 (66%) patients, whereas at least one DSM diagnosis was prese nt in 23 (18%) patients. The number of DCPR diagnoses was almost the triple of DSM criteria. While patients who were given a DSM diagnosis frequently had additional DCPR diagnoses, many patients with DCPR criteria did not ful fill any DSM criteria. Four DCPR syndromes appeared to be particularly freq uent: demoralization, type A behavior, irritable mood and alexithymia. Conc lusions: The joint use of DSM and DCPR criteria was found to improve the id entification of psychological factors which could result in a worsening of quality of life in heart-transplanted patients. Copyright (C) 2001 S.Karger AG, Basel.