Psychosocial and Psychiatric Aspects of Patients Awaiting Liver Transplant

Introduction Psychosocial and psychiatric aspects influence adherence to treatment and, consequently, the prognosis of liver transplantation. Psychosocial and psychiatric pretransplant assessment helps physicians to make clinical and therapeutic decisions. Aim To describe psychosocial and psychiatric aspects of patients awaiting liver transplant at the Coimbra University Hospital Centre. Methods A psychosocial and clinical evaluation questionnaire developed for our study was responded by 31 patients referred for psychological/psychiatric assessment to the Liaison Psychiatry Consultation at Coimbra University Hospital Centre, during the year of 2012. Results Mean age was 48 years. 52% of them were females and 71% were married. Mean years of shooling was 7 years. At the time of the evaluation 35% were working, 19% were not actively working due to their hepatic disease and 23% were unemployed. The main causes for transplant were alcoholic liver disease (55%) and familial amyloidotic polyneuropathy (26%). More than half of patients (58%) had psychiatric history, mostly alcoholism and depression. At the time of evaluation, 42% presented depressive and/or anxiety symptoms. 19% did not reveal full understanding about their liver disease, mainly related to transplant surgical complications and medication side effects. Social and medical satisfaction was reported by 58% and non and poor satisfaction was identified in 3% and 26%,respectively. Conclusions Results indicate that psychosocial and psychiatric risk factors of nonadherence behavior after transplant are frequent on patients awaiting liver transplant. Psychological/psychiatric assessment is very important for selection and orientation of these patients.