Distress and alexithymia in lung recipients - psychosocial strains and associations with chronic allograft dysfunction.

QUESTIONS UNDER STUDY: In recent years, distress and alexithymia have been recognised as psychosocial factors related to both somatic and psychosomatic diseases. In this study distress and alexithymia and their associations with physical parameters were investigated in lung recipients. METHODS: The study, which included 76 patients after a lung transplant, measured psychological distress (Symptom Checklist, SCL-K-9) and alexithymia (Toronto Alexithymia Scale, TAS-20). Physical health was assessed by means of lung function (FEV1), exhaled nitric oxide (eNO), and comorbidity (CCI) at the time of the questionnaire survey. A bronchiolitis obliterans syndrome (BOS) was assessed at the time of the questionnaire survey and one year later. RESULTS: Mean values of distress were found to be significantly higher in lung recipients than in a normal community sample, and mean values of alexithymia were significantly higher in lung patients than in healthy persons. There is a significant positive correlation between distress and BOS at the time of the questionnaire survey (p = .008). Distress is a predictor for new-onset BOS one year after the questionnaire survey (p = .026). No significant correlations were found between alexithymia and physical parameters. CONCLUSIONS: Lung transplants go hand-in-hand with increased alexithymia and psychological distress. In addition, psychological distress may contribute to the development of BOS. This association underlines the importance of psychosocial support after lung transplantation.

Lung function, sociodemographic characteristics, and psychological reaction to transplant associated with chronic stress among lung recipients.

Chronic stress is a well-known consequence of somatic diseases. In this study, we investigated whether physical, sociodemographic, or transplant-related psychological factors were associated with the patient's chronic stress level. A cross-sectional study enrolling 76 patients measured chronic stress (Screening Scale, Screening Subscale of Chronic Stress of the Trier Inventory for the Assessment of Chronic Stress) and the emotional effects of the transplant (Transplant Effects Questionnaire), as well as physical and sociodemographic conditions (lung function, bronchiolitis obliterans syndrome, working status, and parenting). Chronic stress after a lung transplant was significantly lower than in a normal community sample. In the multiple regression analysis, worries concerning the transplant were significantly associated with the patient's chronic stress, but not with physical or sociodemographic parameters, nor with interactions between physical and psychological parameters. These results underscore the importance of transplant-related worries, regardless of the patient's current state of health.