Changes in Mental Health Among Living Kidney Donors After Donation: A Matched Control Study.

Abstract

Introduction Research on mental health of living kidney donors before and after donation is hampered by the lack of a suitable control group. In this study, we used a matched control group from the general population to compare changes in mental health over time. Methods Living kidney donors (N=125) completed the Brief Symptom Inventory (BSI) and the Mental Health Continuum Short Form (MHC-SF) before and 3 months after donation to measure psychological complaints and wellbeing. Median time between the two measurement points was 5.5 months. A matched control group from the general population was generated from a large prospective cohort study on mental health. We used data on BSI and MHC-SF from two measurements with an interval of 6 months in between. Controls were matched on gender, baseline BSI and MHC-SF scores. Mann-Whitney tests on difference scores of the BSI and MHC-SF were used as well as the Jacobson and Truax classification of clinically relevant change on the BSI. Results Donors and controls did not differ significantly on difference scores of psychological complaints and wellbeing. According to the Jacobson and Truax classification, 2 donors and 4 controls showed a significant decrease in psychological complaints which was clinically relevant for 1 donor and 2 controls. Ten donors and 5 controls showed a significant increase in psychological complaints, which was clinically relevant for 6 donors and 2 controls. The changes were not significantly different between donors and controls (Pearson Chi-Square, p=0.459). Discussion There was no evidence for clinically relevant change among the majority of donors in the first three months after donation. In line with earlier research, five percent of donors experienced an increase in psychological complaints. These changes were not significantly different from changes found in the general population over the same time period. A question for future research is whether living donation has the same impact as other life events on mental health and which characteristics make donors vulnerable for this effect.