Quality of life and psychopathology of patients awaiting kidney/pancreas transplants

Objective Patients awaiting kidney/pancreas transplants are suffering from ESRD or severe IDDM, which may contribute to renal insufficiency with or without other medical complications such as diabetic neuropathy. Such patients may experience psychopathological distress that can impair their daily lives. The aim of this study was to assess the QOL, lifetime and current DSM-IV Axis-I and II disorders, sub-threshold mood and panicagoraphobic phenomenology in a large sample of ESRD and IDDM patients waiting kidney-pancreas transplants. Methods Consecutive transplant candidates of both genders aged between 18 and 65 years were enrolled (n = 227). Axis-I and -II diagnoses were determined by experienced clinicians using SCID-I and II. Patients were also administered MOODS-SR (self-report) and PAS-SR questionnaires to assess mood and panicagoraphobic spectrum, and the Q-LES-Q questionnaire to assess QOL, enjoyment and satisfaction. Results The prevalence of current Axis-I disorders was 13.2%. The most common current axis-I disorders were agoraphobia (4.8%) and major depressive episode (4.0%). No difference in the distribution of Axis I disorders between the two groups (ESRD and IDDM) was found. QOL among the sample study was overall poorer than that of a healthy adult control population. Conclusions The prevalence of current mental disorders was approximately three times higher compared to the general Italian population, emphasising that the need for transplantation plays an important role in patients' psychopathology and underlines the importance of careful evaluation of sub-syndromal symptoms.