Transplantation |

Those Awaiting Lung Transplant Commonly Suffer Psychiatric Symptoms Regardless of Psychiatric Comorbidity FREE TO VIEW

Abhay Vakil, MBBS; Michael Wilson, MD; Pujan Kandel, MD; Chaitanya Undavalli, MBBS; Shannon Dunlay, MD; Cassie Kennedy, MD
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Mayo Clinic, Rochester, MN

Chest. 2015;148(4_MeetingAbstracts):1084A. doi:10.1378/chest.2275550
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SESSION TITLE: Transplantation Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Although pre-existing co-morbid psychiatric diagnoses have been described pre-lung transplant, little is known about the prevalence or burden of active depression, anxiety, and stress symptoms pre-transplant.

METHODS: We retrospectively reviewed all patients who underwent lung transplantation from 2000-2013 at Mayo Clinic, Rochester, Minnesota. Re-transplant and multi-organ transplant recipients were excluded. A pre-transplant questionnaire assessed active symptoms. Patients with anxiety, nervousness, or fear symptoms were defined as having anxiety symptoms. Patients reporting anhedonia, difficulty concentrating, irritability, low mood, or suicidal ideation were considered as having depression-related emotional symptoms (DRES). Patients with sleep disturbance/sleepiness, change in libido or pain symptoms were considered as possible depression-related physical symptoms (DRPS). Stress was measured in a five-point Likert scale with ≥3 indicating moderate to severe stress.

RESULTS: Among 144 lung transplant patients, 102 (71%) completed self-reported questionnaires within 1 year of transplant and were included. Patients were a median of 57-years old (IQR 51-62) and 50% male. Thirty-one patients had a history of depression (30.4%) and twenty-five (24.5%) patients had a history of anxiety. Approximately four percent reported a history of abuse. Forty-two percent of patients awaiting lung transplant experience DRES, anxiety, or moderate to high stress. A total of 17 (16.7%) patients reported DRES, with 9.8% reporting difficulty concentrating, 4.9% irritability, 4.9% low mood, 5.9% anhedonia, and 1% suicidal thoughts. 53 (52%) had DRPS suggesting these symptoms may be difficult to separate from chronic illness. Thirteen patients (12.7%) reported anxiety, 24 (23.5%) with high stress, and 9 (8.8%) with both DRES and anxiety. Interestingly symptomatic patients were not necessarily those with a diagnosis of mood disorder. Only three (17.6%) patients with DRES had a prior diagnosis of depression and only 6 (46.1%) patients with anxiety symptoms had a diagnosis of anxiety.

CONCLUSIONS: Pre-lung transplant distress manifested as stress, anxiety, or depressive symptoms. These symptoms are common pre-lung transplant and not isolated to patients with pre-existing psychiatric diagnoses.

CLINICAL IMPLICATIONS: Interventions should be developed to target stress reduction, DRES, and anxiety symptoms pre-lung transplant for symptomatic patients regardless of psychiatric history.

DISCLOSURE: The following authors have nothing to disclose: Abhay Vakil, Michael Wilson, Pujan Kandel, Chaitanya Undavalli, Shannon Dunlay, Cassie Kennedy

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