Assessment of preoperative psychological state of patients with liver transplantation

Abstract

To assess the preoperative depression and anxiety levels of the patients undergoing liver transplantation (LT). Zung self-rating depression scale (SDS) and Zung self-rating anxiety scale (SAS) were used to assess the preoperative depression and anxiety levels of 40 patients undergoing LT, 40 patients with gastrointestinal cancer, and 40 patients undergoing cholecystectomy. The preoperative anxiety levels of the patients undergoing LT, with gastrointestinal cancer, and undergoing cholecystectomy were all significantly higher than that of the national norm (all P < 0.01), without significant differences among the 3 groups of patients. The depression level of the patients undergoing LT was significantly higher than those of the national norm, and the patients with gastrointestinal cancer and undergoing cholecystectomy (all P < 0.01). There were not significant differences in the preoperative depression and anxiety levels between the patients with gastrointestinal cancer and those undergoing cholecystectomy. The depressive rate of the patients undergoing LT was 40.0% (16/40), significantly higher than those of cholecystectomy group (17.5%) and cancer resection group (15.0%), and the depression score of the 6 female patients undergoing LT was 53, significantly higher than that of the male patients in the same group (P < 0.01). There was no significant differences in the depression and anxiety levels between the patients undergoing living donor liver transplantation (LDLT) and the patients undergoing orthotopic liver transplantation (OLT). Educational level was not correlated with the preoperative anxiety and depression levels. Patients scheduled for LT have high risks of preoperative depression and anxiety, especially the former. Suitable pre-medication, optimal psychosocial assessment, and treatment, especially for the female patients, are needed.