Psychiatric disorders and psychological distress in patients undergoing evaluation for lung transplantation: a national cohort study.

Abstract

We sought to investigate type and prevalence of psychiatric disorders and psychological distress in patients being evaluated for lung transplantation. One hundred eighteen patients were assessed [74% with chronic obstructive pulmonary disease (COPD)] with the MINI Neuropsychiatric Interview, the General Health Questionnaire (GHQ), and Hospital Anxiety Depression Scale (HADS). Spirometry and the 6-min walk test (6MWT) assessed lung function with data subject to multivariate regression analyses. Current and lifetime prevalence for mental disorders were 41.5% and 61.0% respectively, with anxiety (39.8% of patients), mood disorders (11.8%), and subsyndromal disorders (8.7%) identified. 15% of patients reported feelings of panic during the last week, 9% reported hopelessness, and 3% felt that life was not worth living. Statistically significant correlates were derived for HADS-depression with lung function (P=.0012) and 6MWT (P=.030) for the entire group (P=.012), and with lung function (P=.030) for COPD patients (P=.045), for whom higher chronic GHQ-scores correlated with poorer lung function (P=.009). In multivariate regression analysis, history of mental disorder was strongest predictor of current distress. Our findings underline the importance of assessing past, current, and sub-syndromal psychiatric disorders in addition to levels of distress in transplant candidates, with prospective studies needed to investigate impact on long-term outcome after transplantation.