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July 1, 1983, Vol 250, No. 1 >
ARTICLE | July 1, 1983

Psychiatric Morbidity in Long-term Renal Transplant Recipients and Patients Undergoing Hemodialysis: Title and subTitle BreakA Comparative Study FREE

Thomas P. Kalman, MD; Peter G. Wilson, MD; Concetta M. Kalman, RN
[+] Author Affiliations

Read before the annual meeting of the American Psychosomatic Society, Denver, March 28, 1982, and the annual meeting of the American Academy of Psychosomatic Medicine, Chicago, Nov 21, 1982.

Reprint requests to 340 E 57th St, New York, NY 10022 (Dr Kalman).


JAMA. 1983;250(1):55-58. doi:10.1001/jama.1983.03340010037025
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References

This study assessed and compared psychiatric morbidity in long-term (five years or longer) renal transplant recipients and patients undergoing hemodialysis. Fifty-seven of 98 transplant recipients and 44 of 89 patients undergoing dialysis returned questionnaires designed to collect demographic information and to detect psychiatric morbidity. The two groups differed significantly only in that the patients undergoing dialysis were both older and medically sicker than the transplant recipients. Forty-six percent of the transplant group and 48% of the dialysis group could be identified as psychiatrically impaired either by their scores on the General Health Questionnaire or by a history of prior psychiatric treatment. The finding of nearly equivalent psychiatric morbidity in these two groups does not support the often-held notions about psychological advantages of transplantation over dialysis. We conclude that psychiatric morbidity in patients with chronic renal failure is high and appears not to be related to the choice of treatment.

(JAMA 1983;250:55-58)

REFERENCES

1 +
Gentry WD, Davis GC:  Cross-sectional analysis of psychological adaptation to chronic hemodialysis . J Chronic Dis 1972;;25:545-550.
2 +
Reichsman F, Levy NB:  Problems in adaptation to maintenance hemodialysis . Arch Intern Med 1972;;130:859-865.
3 +
Foster FG, Cohn GL, McKegney FB:  Psychobiological factors and individual survival on chronic renal hemodialysis: A two year followup: Part I . Psychosom Med 1973;;35:64-82.
4 +
Holcomb JL, MacDonald RW:  Social functioning of artificial kidney patients . Soc Sci Med 1973;;7:109-119.
5 +
Goldberg RT:  Vocational rehabilitation of patients on long-term hemodialysis . Arch Phys Med Rehabil 1974;;55:60-65.
6 +
Levy NB, Wynbrandt GD:  The quality of life on maintenance hemodialysis . Lancet 1975;; 1:1328-1330.
7 +
Farmer CJ, Bewick M, Parsons V, et al:  Survival on home haemodialysis: Its relationship with physical symptomatology, psycho-social background and psychiatric morbidity . Psychol Med 1979;;9:515-523.
8 +
Procci WR:  A comparison of psycho-social disability in males undergoing maintenance hemodialysis or following cadaver transplantation . Gen Hosp Psych 1980;;2:255-261.
9 +
Simmons RG, Kamstra-Hennen L, Thompson CR:  Psycho-social adjustment five to nine years posttransplant . Transplant Proc 1981;; 13:40-43.
10 +
Kaplan De-Nour A:  Social adjustment of chronic dialysis patients . Am J Psychiatry 1982;; 139:97-100.
11 +
Kramer MS, Hudachek D, Raja RM, et al:  For rehabilitation—dialysis or transplantation? Dial Transplant 1975;;4:56-62.
12 +
Burns S, Johnson HK:  Rehabilitation potential of a dialysis versus a transplant population . Dial Transplant 1976;;5:54-56.
13 +
Blogg CR, Anderson M, Shoddle C, et al:  Rehabilitation of patients treated by dialysis or transplantation . Proc Dial Transplant Forum 1973;;3:181-184.
14 +
Holdsworth SR, deKretsen DM, Atkins RC:  A comparison of hemodialysis and transplantation in reversing the uremic disturbance of male reproductive function . Clin Nephrol 1978;;10:146-150.
15 +
Procci WR, Hoffman KL, Chatterjel SN:  Persistent sexual dysfunction following renal transplantation . Dial Transplant 1978;;7:891-894.
16 +
Rennie D:  Renal rehabilitation—where are the data? N Engl J Med 1981;;304:351-352.
17 +
Farmer CJ, Snowden SA, Parsons V:  The prevalence of psychiatric illness among patients on home haemodialysis . Psychol Med 1979;;9:509-514.
18 +
Livesley WJ:  Psychiatric disturbance and chronic haemodialysis . Br Med J 1979;;22:306.
19 +
Simmons RG, Klein SD, Simmons RL: Gift of Life: The Social and Psychological Impact of Organ Transplantation . New York, John Wiley & Sons Inc, 1977;.
20 +
Coene R:  Dialysis or transplant: One patient's choice . Hastings Cent Rep 1978;;8:5-7.
21 +
Howard RJ, Kjellstrand CM, Sutherland DER, et al:  Dialysis vs transplant . JAMA 1978;; 239:830.
22 +
Leakey JW:  The choice between dialysis and transplantation . Transplant Proc 1973;; 5:1119-1120.
23 +
Sophie LR:  Life satisfaction and social function: Post-transplant self-evaluation . Dial Transplant 1979;;8:1198-1202.
24 +
Goldberg DP: The Detection of Psychiatric Illness by Questionnaire , Maudsley Monograph 21. London, Oxford University Press, 1972;.
25 +
Knights EB, Folstein MF:  Unsuspected emotional and cognitive disturbance in medical patients . Ann Intern Med 1977;;87:723-724.
26 +
DePaulo JR, Folstein MF:  Psychiatric disturbances in neurological patients: Detection, recognition and hospital course . Ann Neurol 1978;;4:225-228.
27 +
Beck AT, Weissman A:  The measurement of pessimism: The Hopelessness Scale . J Consult Clin Psychol 1974;;42:1-5.
28 +
Schmale AH:  Relationship of separation and depression to disease: A report on a hospitalized medical population . Psychosom Med 1958;; 20:259-277.
29 +
Schmale AH, Engel GO:  The giving up-given up complex illustrated on film . Arch Gen Psychiatry 1967;;17:135-145.
30 +
Yanagida EH, Streltzer J:  Limitations of psychological tests in a dialysis population . Psychosom Med 1979;;41:557-565.
31 +
Kemph JP:  The kidney or the machine? JAMA 1977;;237:2532.

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1 +
Gentry WD, Davis GC:  Cross-sectional analysis of psychological adaptation to chronic hemodialysis . J Chronic Dis 1972;;25:545-550.
2 +
Reichsman F, Levy NB:  Problems in adaptation to maintenance hemodialysis . Arch Intern Med 1972;;130:859-865.
3 +
Foster FG, Cohn GL, McKegney FB:  Psychobiological factors and individual survival on chronic renal hemodialysis: A two year followup: Part I . Psychosom Med 1973;;35:64-82.
4 +
Holcomb JL, MacDonald RW:  Social functioning of artificial kidney patients . Soc Sci Med 1973;;7:109-119.
5 +
Goldberg RT:  Vocational rehabilitation of patients on long-term hemodialysis . Arch Phys Med Rehabil 1974;;55:60-65.
6 +
Levy NB, Wynbrandt GD:  The quality of life on maintenance hemodialysis . Lancet 1975;; 1:1328-1330.
7 +
Farmer CJ, Bewick M, Parsons V, et al:  Survival on home haemodialysis: Its relationship with physical symptomatology, psycho-social background and psychiatric morbidity . Psychol Med 1979;;9:515-523.
8 +
Procci WR:  A comparison of psycho-social disability in males undergoing maintenance hemodialysis or following cadaver transplantation . Gen Hosp Psych 1980;;2:255-261.
9 +
Simmons RG, Kamstra-Hennen L, Thompson CR:  Psycho-social adjustment five to nine years posttransplant . Transplant Proc 1981;; 13:40-43.
10 +
Kaplan De-Nour A:  Social adjustment of chronic dialysis patients . Am J Psychiatry 1982;; 139:97-100.
11 +
Kramer MS, Hudachek D, Raja RM, et al:  For rehabilitation—dialysis or transplantation? Dial Transplant 1975;;4:56-62.
12 +
Burns S, Johnson HK:  Rehabilitation potential of a dialysis versus a transplant population . Dial Transplant 1976;;5:54-56.
13 +
Blogg CR, Anderson M, Shoddle C, et al:  Rehabilitation of patients treated by dialysis or transplantation . Proc Dial Transplant Forum 1973;;3:181-184.
14 +
Holdsworth SR, deKretsen DM, Atkins RC:  A comparison of hemodialysis and transplantation in reversing the uremic disturbance of male reproductive function . Clin Nephrol 1978;;10:146-150.
15 +
Procci WR, Hoffman KL, Chatterjel SN:  Persistent sexual dysfunction following renal transplantation . Dial Transplant 1978;;7:891-894.
16 +
Rennie D:  Renal rehabilitation—where are the data? N Engl J Med 1981;;304:351-352.
17 +
Farmer CJ, Snowden SA, Parsons V:  The prevalence of psychiatric illness among patients on home haemodialysis . Psychol Med 1979;;9:509-514.
18 +
Livesley WJ:  Psychiatric disturbance and chronic haemodialysis . Br Med J 1979;;22:306.
19 +
Simmons RG, Klein SD, Simmons RL: Gift of Life: The Social and Psychological Impact of Organ Transplantation . New York, John Wiley & Sons Inc, 1977;.
20 +
Coene R:  Dialysis or transplant: One patient's choice . Hastings Cent Rep 1978;;8:5-7.
21 +
Howard RJ, Kjellstrand CM, Sutherland DER, et al:  Dialysis vs transplant . JAMA 1978;; 239:830.
22 +
Leakey JW:  The choice between dialysis and transplantation . Transplant Proc 1973;; 5:1119-1120.
23 +
Sophie LR:  Life satisfaction and social function: Post-transplant self-evaluation . Dial Transplant 1979;;8:1198-1202.
24 +
Goldberg DP: The Detection of Psychiatric Illness by Questionnaire , Maudsley Monograph 21. London, Oxford University Press, 1972;.
25 +
Knights EB, Folstein MF:  Unsuspected emotional and cognitive disturbance in medical patients . Ann Intern Med 1977;;87:723-724.
26 +
DePaulo JR, Folstein MF:  Psychiatric disturbances in neurological patients: Detection, recognition and hospital course . Ann Neurol 1978;;4:225-228.
27 +
Beck AT, Weissman A:  The measurement of pessimism: The Hopelessness Scale . J Consult Clin Psychol 1974;;42:1-5.
28 +
Schmale AH:  Relationship of separation and depression to disease: A report on a hospitalized medical population . Psychosom Med 1958;; 20:259-277.
29 +
Schmale AH, Engel GO:  The giving up-given up complex illustrated on film . Arch Gen Psychiatry 1967;;17:135-145.
30 +
Yanagida EH, Streltzer J:  Limitations of psychological tests in a dialysis population . Psychosom Med 1979;;41:557-565.
31 +
Kemph JP:  The kidney or the machine? JAMA 1977;;237:2532.

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