Relationship of psychiatric morbidity and psychosocial factors in organ transplant candidates

The purpose of this study was to explicate the statistical relationship between psychiatric diagnosis and psychosocial adjustment and health status in organ transplant candidates. Interview and psychometric data were obtained from 311 heart, kidney, lung, and liver transplant candidates. Over 60% of the cases met criteria for DSM-III-R Axis I diagnoses, nearly 32% for Axis II disorders. Axis II disorders were significantly associated with medical compliance problems, whereas Axis I disorders were predominantly associated with poorer psychosocial adjustment and health status. Nearly one-quarter of the patients had comorbid Axis I and Axis II disorders, and evidenced poorest premorbid coping and degree of marital harmony, defining a subgroup at special risk for problematic outcome. The incidence of psychiatric disorders and their association with lack of psychosocial resources and poor physical health supports the use of systematic, multidisciplinary assessment of transplant candidates.