Prevalence of Psychological Distress and Stress Moderators in UK Transplant Candidates:

Abstract

Purpose The UK is currently standardising pre-transplant psychological assessments. This data forms part of a longitudinal study investigating pre-transplant psychological risk factors associated with poor medical outcome post transplant. This study examines prevalence of distress in UK transplant candidates and potentially modifiable psychological risk factors. Methods and Materials 109 consecutive transplant candidates completed the Hospital Anxiety and Depression Scales (HADS) and Millon Behavioural Medicine Diagnostic inventory (MBMD). (62% male, 82% awaiting lung, 18% awaiting heart transplant). Results 61.5% transplant candidates reported HADS scores within the clinically significant range with only 38.5% reporting scores below cut-offs. [figure 1] HADS scores in clinical range were associated with increased prevalence of negative stress moderators: Illness Apprehension X2 =10.44 p<0.01(Df=1); Future Pessimism X2=4.17, p<0.05 (Df=1); Problematic Compliance X2=37.73 p<0.001 (Df=1); Adjustment Difficulties X2=22.82, p<0.001 (Df=1). Conclusions A high prevalence of anxiety and/or depression was found in transplant candidates and this was associated with factors that are amenable to psychological therapy. These factors included preoccupation with and rumination on illness, hopelessness, ambivalence about effectiveness of treatment and difficulties with acceptance. This study has identified a clear need for evidence-based psychological care. This study also highlights the utility of standardised psychometric measures to identify prevalence of distress in transplant candidates. Future studies should focus upon effectiveness of psychological interventions tailored for transplant candidates.