Testing ters and madrs on 567 pre-OLTx patients

Abstract

Background and aims:

Ortothopic Liver Transplantation (OLTx) is a therapeutic option for selected patients with severe hepatopatic diseases. Resources are precious and limited, and selection of “ideal” candidates is tough but necessary; the psychiatrist is involved in the assessment of compliance and adherence to the therapeutic process by the patient. Moreover, the inclusion in the waiting list for OLTx activates multiple psychological reactions in the patient, mainly anxiety and depression, and a need to test patients' coping capacity is also crucial.

Methods:

567 patients from the Liver Transplantation Surgery Unit of Modena General Hospital were assessed by professionally-trained psychiatrists between January 2002 and December 2005. After a standard psychiatric assessment, the Transplant Evaluation Rating Scale (TERS) and Montgomery-Asberg Depression Rating Scale (MADRS) scales were administered to each patient. The TERS scale was specifically developed to test the attitude of the patient to receive a transplant. The MADRS quantifies the presence of anxious and depressive symptoms.

Results:

TERS and MADRS scores show a statistically significant inverse correlation one to each other: patients showing high levels of anxious and/or depression symptoms appear to be worse candidates at the TERS evaluation.

Conclusions:

Psychiatric assessment of patients waiting for OLTx is relevant, not only for selection of candidates, but also to activate a psychological support and/or a psychopharmacological therapy, to improve patients' coping strategies in facing both a debilitating physical illness and a difficult therapeutic pathway.