Preoperative Psychiatric Evaluation Research Articles

Psychiatric aspects of organ transplantation

DURING the past 30 years, organ transplantation has moved from being an experimental procedure to an accepted treatment for several disorders. This review discusses the most common psychiatric complications as well as psychological benefits that children, adolescents, and adult transplantation patients and their families experience. Preoperative psychiatric evaluation; psychiatric aspects of living, related, and brain-dead donors; and the support provided by the transplantation unit staff are also discussed. During the early 1950s, Hume¹performed several cadaveric renal transplantations, but it was not until 1954, when Murray and colleagues^2,3successfully transplanted a kidney from one identical twin brother to the other that long-term success in transplantation began to be achieved. In the 30 years since that pioneering work, long-term survival has significantly increased. This has been largely due to the increased experience of surgeons, refinement of surgical technique, improvements in tissue typing and matching, more careful selection of candidates,

Psychiatric Aspects of Organ Transplantation

DURING the past 30 years, organ transplantation has moved from being an experimental procedure to an accepted treatment for several disorders. This review discusses the most common psychiatric complications as well as psychological benefits that children, adolescents, and adult transplantation patients and their families experience. Preoperative psychiatric evaluation; psychiatric aspects of living, related, and brain-dead donors; and the support provided by the transplantation unit staff are also discussed. During the early 1950s, Hume1performed several cadaveric renal transplantations, but it was not until 1954, when Murray and colleagues2,3successfully transplanted a kidney from one identical twin brother to the other that long-term success in transplantation began to be achieved. In the 30 years since that pioneering work, long-term survival has significantly increased. This has been largely due to the increased experience of surgeons, refinement of surgical technique, improvements in tissue typing and matching, more careful selection of candidates,

PSYCHIATRIC FINDINGS IN CARDIOTOMY PATIENTS

Thirty-six patients who underwent open heart surgery were given preoperative psychiatric evaluations to determine whether postoperative expressions of delirium might be related to preexisting but covert psychiatric illness. Findings included a poor postoperative prognosis for patients with preoperative organic brain syndrome and a relatively high incidence of postcardiotomy delirium among those who had preoperative psychiatric symptoms. The authors suggest the use of more refined projective techniques to detect minimal organic impairment that might carry an increased risk of postoperative morbidity and mortality. Also, with more definitive parameters for determining preoperative psychiatric difficulties, they conclude, the predictability of postcardiotomy delirium may be enhanced.

Psychiatric findings in cardiotomy patients.

Thirty-six patients who underwent open heart surgery were given preoperative psychiatric evaluations to determine whether postoperative expressions of delirium might be related to preexisting but covert psychiatric illness. Findings included a poor postoperative prognosis for patients with preoperative organic brain syndrome and a relatively high incidence of postcardiotomy delirium among those who had preoperative psychiatric symptoms. The authors suggest the use of more refined projective techniques to detect minimal organic impairment that might carry an increased risk of postoperative morbidity and mortality. Also, with more definitive parameters for determining preoperative psychiatric difficulties, they conclude, the predictability of postcardiotomy delirium may be enhanced.

MECHANISMS OF PSYCHOSOCIAL ADJUSTMENT IN PATIENTS SEEKING " FACE-LIFT" OPERATION.

The clinical study and follow-up of 106 consecutive patients requesting cosmetic surgery for facial evidences of aging revealed a favorable subjective response in nearly all who underwent surgery. This favorable response included more positive attitudes toward themselves and the relief of depressive symptoms. All the patients showed striking similarities in social attitudes and motivations for surgery. Those below the age of 40 who requested surgery demonstrated greater past and present problems in personal adjustment, and such patients deserve careful preoperative psychiatric evaluation. The “face-lift” operation not only provides a definite realistic improvement in appearance but also meets the personality needs of these patients in their endeavor to re-establish previous adjustment patterns.