Psychopathological aspects of kidney transplantation: Efficacy of a multidisciplinary team

作     者：Concetta De Pasquale Massimiliano Veroux Luisa Indelicato Nunzia Sinagra Alessia Giaquinta Michele Fornaro Pierfrancesco Veroux Maria L Pistorio 

作者机构：Vascular Surgery and Organ Transplant Unit Department of Surgery Transplantation and Advanced Technologies University Hospital of Catania 95124 Catania Italy Department of Formative Sciences University of Catania 95124 Catania Italy 

出 版 物：《World Journal of Transplantation》 (世界移植杂志)

年 卷 期：2014年第4卷第4期

页      面：267-275页

学科分类：10[医学] 

主　　题：Psychiatric consultation Psychological care Kidney transplantation Therapeutic compliance Social and family support 

摘      要：Renal transplantation is a well established treatment for end-stage renal disease, allowing most patients to return to a satisfactory quality of life. Studies have identified many problems that may affect adaptation to the transplanted condition and postoperative compliance. The psychological implications of transplantation have important consequences even on strictly physical aspects. Organ transplantation is very challenging for the patient and acts as an intense stressor stimulus to which the patient reacts with neurotransmitter and endocrine-metabolic changes. Transplantation can result in a psychosomatic crisis that requires the patient to mobilize all bio-psychosocial resources during the process of adaptation to the new foreign organ which may result in an alteration in self-representation and identity, with possible psychopathologic repercussions. These reactions are feasible in mental disorders, e.g., post-traumatic stress disorder, adjustment disorder, and psychosomatic disorders. In organ transplantation, the fruitful collaboration between professionals with diverse scientific expertise, calls for both a guarantee for mental health and greater effectiveness in challenging treatments for a viable association between patients, family members and doctors. Integrated and multidisciplinary care should include uniform criteria and procedures for standard assessments, for patient autonomy, adherence to therapy, new coping strategies and the adoption of more appropriate lifestyles.