Journal Article Annotations
2021, 4th Quarter
Annotations by Sarah R. Andrews, MD
This single-study retrospective study evaluated 49 lung transplant recipients and 14 lung transplant candidates for anxiety and depression symptoms through the Hospital Anxiety and Depression Scale. Coping strategies were also assessed by using the Coping Inventory for Stressful Situations questionnaire. From these 63 participants, 11 (17%) and 18 (29%) patients exhibited depressive and anxiety symptoms, respectively. Anxiety was more common in patients who experienced lockdown outside versus inside their usual home. Task-focused strategies were the preferred coping strategy for patients. No significant differences were found between lung transplant recipients and candidates.
Strength and weaknesses:
The strength of this study is involving both coping strategies as well as evaluating anxiety and depression. It also has limitations, including the small sample size from one location given that patients from different countries or populations may have differing responses to the COVID-19 pandemic.
Anxiety and depression are common in the lung transplant population, both in recipients and candidates, and the COVID-19 pandemic has worsened the risk of psychiatric symptoms in this fragile population. The study is relevant to the Cl-L psychiatrist in helping to identify anxiety or depression-provoking situations within this population.
This retrospective cohort study included 236 liver transplant recipients with alcohol-induced liver disease from one transplant center from 2000 until 2012. From these liver recipients, over 90 percent had completed pre-transplant treatment and over half attended Alcoholics Anonymous (AA). After five years post-transplant, 16.3% who had completed pre-transplant treatment relapsed, while 8.2% of those who engaged in weekly AA meetings had relapsed. Smoking prior to transplant was associated with relapse, and smoking at transplant was associated with death.
Strengths and weaknesses
This study had several strengths, including the ongoing close follow-up of transplant recipients regarding alcohol consumption. One weaknesswas the unclear objective assessment of evaluating patients’ alcohol consumption post-transplant given that return to alcohol consumption when self-reported can be underreported. Furthermore, AA meetings and treatment pre-transplant can vary significantly in quality.
This study is relevant to transplant psychiatrists evaluating and managing liver transplant recipients with alcohol-induced liver disease. The association between smoking prior to and following transplant with morbidity and mortality will be helpful as we guide patients through the transplant process and help them reduce their alcohol and tobacco consumption.