ABSTRACT
Reported is the change in cognitive function after neuronal cell transplantation as a treatment for basal ganglia stroke. Nine subjects (two controls, seven transplants), all over 2 years post stroke, completed a comprehensive neuropsychological test battery prior to and 6 months after treatment. Four transplanted subjects who had strokes in the nondominant hemisphere showed marked improvement on the Rey Complex Figure, a test of visuospatial/constructional ability and nonverbal memory.
Subject(s)
Basal Ganglia Cerebrovascular Disease/surgery , Brain Infarction/surgery , Cognition , Neurons/transplantation , Aged , Basal Ganglia Cerebrovascular Disease/physiopathology , Basal Ganglia Cerebrovascular Disease/psychology , Brain Infarction/physiopathology , Brain Infarction/psychology , Dominance, Cerebral , Humans , Mental Recall , Middle Aged , Neuropsychological Tests , Single-Blind Method , Stereotaxic Techniques , Task Performance and AnalysisABSTRACT
This study examined depression, anxiety, and anger-hostility symptom levels, as well as overall quality of life, in a cohort of 50 lung and heart-lung transplant recipients. Only the subjects' mean anxiety symptoms were substantially elevated over normative levels. However, nearly half of the sample showed clinically significant distress in one or more of the three symptom areas. Pretransplant psychiatric history, educational level, posttransplant caregiver support, and health concerns were the most important independent correlates of the recipients' psychological outcome. Low sense of mastery and poorer physical functional status also showed some evidence of association with mental health.
Subject(s)
Affective Symptoms/diagnosis , Heart-Lung Transplantation/psychology , Lung Transplantation/psychology , Quality of Life , Adult , Affective Symptoms/psychology , Anger , Anxiety/diagnosis , Anxiety/psychology , Cohort Studies , Depression/diagnosis , Depression/psychology , Female , Hostility , Humans , Male , Middle AgedABSTRACT
BACKGROUND: Dispositional optimism and adaptive coping styles have been shown to correlate with each other and with physical and psychological well-being in a number of studies with medical patients. Few studies in the transplant literature evaluate psychological characteristics of patients across medical diagnoses. A comparison of optimism and coping styles among candidates for liver and lung transplantation is presented. METHOD: Subjects were 73 candidates for lung transplantation at the University of Pittsburgh Medical Center and 76 candidates for liver transplantation at the Pittsburgh VA Healthcare System. All candidates were classified according to medical diagnosis and history of substance abuse (alcohol/drugs or smoking). There were no significant between- or within-group differences on optimism. RESULTS: There was a significant difference within both groups, according to history of substance abuse on the coping style 'acceptance'. There were also significant between-group differences on a number of coping styles. CONCLUSIONS: This preliminary study is intended to suggest direction for future research; studying psychological variables known to impact on health apart from medical diagnosis may provide data pertinent to selection criteria and the design of interventions to more effectively maximize the benefit of transplantation for all concerned.
Subject(s)
Adaptation, Psychological , Liver Transplantation/psychology , Lung Transplantation/psychology , Adult , Female , Health Status , Humans , Male , Mental Health , Middle Aged , Risk Factors , Substance-Related DisordersABSTRACT
Liver transplantation for patients with a history of substance abuse remains controversial. Resumption of heavy alcohol use postoperatively is a threat to long-term survival, but recidivism among transplanted alcoholics is reportedly low. An argument against psychological evaluation prior to transplantation revolves around the speculation that candidates will attempt to portray themselves as more desirable prior to listing with UNOS (United Network for Organ Sharing). This study measured psychological distress, coping styles, optimism, selected personality features, and perception of family environment among 73 U.S. military veterans who were candidates for liver transplantation. Candidates with positive histories of substance abuse revealed significantly more distress, less adaptive coping styles, and more character pathology than their counterparts. The only significant difference according to UNOS listing was on one measure of family environment. Results support preoperative psychological assessment and intervention on a more extensive level for substance abusers and raise questions for future research.
Subject(s)
Liver Transplantation , Substance-Related Disorders/diagnosis , Substance-Related Disorders/psychology , Adaptation, Psychological , Adult , Female , Humans , Male , Middle Aged , Personality Disorders/diagnosis , Severity of Illness IndexABSTRACT
This study examined depression, anxiety, coping styles, optimism, selected personality characteristics, and perception of family environment among candidates for liver transplantation (OLTX); the goal was to measure and empirically describe psychosocial factors reported to impact on the experience and outcome of transplantation. Subjects were 73 US military veterans being considered for OLTX at the VAMC-Pittsburgh (UD) from 1994 to 1996. Psychological evaluation consisted of chart review, consultation with the transplant team, clinical interview and administration of published, standardized, and readily available psychological tests. Candidates displayed above normal levels of situational anxiety and depression, mainly adaptive coping styles, mild optimism, and positive family environments. Factor analysis of the data identified two dimensions of psychological distress, five coping styles, and three types of family environment. The composite MMPI-2 profile for the sample shows marked elevations of the neurotic triad and moderate elevations of psychasthenia and schizophrenia scales. Psychological distress, psychopathology, coping styles, optimism, and perceptions of family environment correlate with each other in the directions suggested by the literature. These findings support previous research with empirical data; results encourage the development of consistent psychological protocols and procedures to evaluate and treat organ transplant candidates.
Subject(s)
Liver Transplantation/psychology , Adaptation, Psychological , Adult , Family , Female , Humans , Male , Middle Aged , Military Personnel/psychology , Personality , United StatesABSTRACT
A protocol to evaluate the psychopathology of candidates for orthotopic (whole organ) liver transplantation (OLTX) is presented. Patients being considered for OLTX at the VA Pittsburgh Healthcare System were routinely referred for psychological evaluation consisting of a clinical interview and battery of standardized tests. The findings on 26 patients corroborate previous reports of psychological distress among transplant candidates. There is also evidence that higher levels of disturbance are observed among patients with a positive history of substance abuse. This study supports the value of standardized testing in the transplant population and suggests directions for further research.
