Posttraumatic Stress Disorder, Quality of Life, and the Subjective Experience in Liver Transplant Recipients

Prog Transplant. 2018 Mar;28(1):70-76. doi: 10.1177/1526924817746680. Epub 2017 Dec 15.

Abstract

Objective: A high prevalence of posttraumatic stress disorder (PTSD) symptoms among transplant recipients has been associated with a low adherence to treatment and poor survival. It is crucial to detect and prevent the development of posttraumatic stress in transplant settings.

Methods: We examined the prevalence of posttraumatic stress symptoms in 3 liver transplant recipients by means of the Essen Trauma Inventory (ETI), a self-report questionnaire. The Short Form-36 was used to assess the perceived health-related quality of life. Patients were asked to indicate the most traumatic events within the context of the liver transplantation procedure.

Results: Five patients (4.9%) fulfilled the criteria for PTSD related to liver disease or transplantation (ETI score greater than 27). In these patients, diagnosis was confirmed by a structured clinical interview. Fourteen (13.6%) patients had a partial PTSD with the ETI score less than 27 and greater than 16. Posttraumatic stress symptoms were significantly associated with perceived poor physical and mental health-related quality of life. Patients reported that the physicians' disclosure of diagnosis was experienced as traumatic, followed by treatment in an intensive care unit and the liver transplantation itself.

Conclusions: The ETI resulted in prevalence rates for PTSD comparable to previous studies in liver transplantation settings. Medical professionals requested additional training in how to deliver severe diagnoses to patients.

Keywords: anxiety; depression; liver transplantation; posttraumatic stress disorder; quality of life.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Humans
  • Liver Transplantation / adverse effects*
  • Liver Transplantation / psychology*
  • Male
  • Middle Aged
  • Quality of Life / psychology*
  • Stress Disorders, Post-Traumatic / diagnosis*
  • Stress Disorders, Post-Traumatic / etiology*
  • Surveys and Questionnaires
  • Transplant Recipients / psychology*
  • Young Adult