Academic journal article International Journal of Clinical and Health Psychology

Mental Health and Quality of Life in Liver Transplant and Cirrhotic Patients with Various Etiologies1

Academic journal article International Journal of Clinical and Health Psychology

Mental Health and Quality of Life in Liver Transplant and Cirrhotic Patients with Various Etiologies1

Article excerpt

ABSTRACT. In this study we aimed to: 1) examine whether there were differences in mental health and quality of life of liver transplant recipients according to etiology that led to transplantation (alcoholic cirrhosis, Hepatitis B/C Virus, hepatocellular carcinoma and others); and 2) to compare mental health and quality of life between liver transplant and cirrhotic patients, according to etiologies that most often lead to liver transplantation (alcoholic and Hepatitis C Virus). Two patient groups participated: 168 transplant recipients and 63 cirrhotic patients. Mental health was assessed by the Hospital Anxiety and Depression Scale and quality of life by the SF-36 Health Survey. We found the following results: 1) statistically significant differences were found in anxiety, depression, general health, and vitality; in all of them, transplant patients due to Hepatitis C Virus showed the highest impairment and transplant patients due to alcoholic cirrhosis showed the lowest deterioration; 2) cirrhotic patients, compared to transplanted, and patients with Hepatitis C Virus, compared to alcoholic liver patients, were the groups with greater biopsychosocial impairment. In the absence of interactive effects between factors groups and etiology, Hepatitis C Virus patients had higher biopsychosocial impairment than alcoholic liver patients, regardless of whether or not they underwent transplant.

KEYWORDS. Biopsychosocial well-being. Liver transplantation. Liver cirrhosis. Etiologies leading to transplant. Ex post facto study.

RESUMEN. En este estudio se plantea: 1) analizar diferencias en salud mental y calidad de vida entre trasplantados hepáticos en función de la etiología desencadenante del trasplante (etílica, Virus de la Hepatitis B/C, hepatocarcinoma y otras), y 2) comparar la salud mental y la calidad de vida entre trasplantados hepáticos y enfermos cirróticos en función de las etiologías que con más frecuencia desencadenan el trasplante hepático (etílica y Virus de la Hepatitis C). Se seleccionaron dos grupos: 168 trasplantados y 63 cirróticos. Se empleó la Escala Hospitalaria de Ansiedad y Depresión y el Cuestionario de Salud SF-36. Los resultaron indicaron: 1) diferencias significativas en las variables ansiedad, depresión, salud general y vitalidad; en todas ellas el mayor deterioro correspondió a trasplantados con el Virus de la Hepatitis C y el menor a etílicos, 2) enfermos cirróticos versus trasplantados hepáticos, y enfermos con el Virus de la Hepatitis C versus etílicos, fueron los grupos con mayor deterioro biopsicosocial. Ante la inexistencia de efectos interactivos entre los factores grupo y etiología, se concluye que los pacientes con Virus de la Hepatitis C presentan mayor deterioro biopsicosocial en comparación con pacientes etílicos, independientemente de que hubieran sido o no trasplantados.

PALABRAS CLAVE. Bienestar biopsicosocial. Trasplante hepático. Cirrosis hepática. Etiologías desencadenantes del trasplante. Estudio ex post facto.

Liver transplantation is a completely consolidated therapy that improves patients' quality of life, although they do not achieve the same levels as the general population (Karam et al., 2003; Sumskiene, Sumskas, Petrauskas, and Kupcinskas, 2006; Taylor, Franck, Gibson, and Dhawan, 2005). Thus, for example, in a study that analyzed healthrelated quality of life in three groups (cirrhotic patients who presented diverse levels of severity -mild, moderate, and severe-, liver transplant patients, and healthy population), it was found that the quality of life of the transplant recipients did not reach the levels of the healthy population, although it was significantly better than that of the cirrhotic patients, especially compared to those who were in advanced stages of the liver disease (Pantiga et al., 2005). Similarly, another study that compared the same groups also found that the best functioning corresponded to the healthy people and the worst to the transplant candidates. …

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