Psychiatric Comorbidity, Health-Related Quality of Life, and Mental Health Service Utilization Among Patients Awaiting Liver Transplant

• Published in: Journal of pain and symptom management Vol. 56; no. 1; pp. 44 - 52
• Main Authors: Saracino, Rebecca M., Jutagir, Devika R., Cunningham, Amy, Foran-Tuller, Kelly A., Driscoll, Mary A., Sledge, William H., Emre, Sukru H., Fehon, Dwain C.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-07-2018; Elsevier Limited
• Subjects: Adult; Aged; Anxiety; barriers; Candidates; Comorbidity; Depression; Disease; End Stage Liver Disease - epidemiology; End Stage Liver Disease - psychology; End Stage Liver Disease - surgery; Female; Health research; Health services utilization; Health status; health-related quality of life; Humans; Liver; Liver diseases; liver transplant; Liver Transplantation; Liver transplants; Male; Mental depression; Mental disorders; Mental Disorders - epidemiology; Mental Disorders - therapy; Mental health; Mental health care; Mental Health Services; Middle Aged; Patient Acceptance of Health Care; Patients; Post traumatic stress disorder; Prevalence; Quality of Life; Self report; Transplants & implants; Trauma; Waiting Lists; anxiety; Depression; health-related quality of life; mental health services; barriers; liver transplant
• ISSN: 0885-3924; 1873-6513
• DOI: 10.1016/j.jpainsymman.2018.03.001

The prevalence of psychiatric disorders and mental health service utilization among patients with end-stage liver disease awaiting transplant remains understudied.
This study assessed the prevalence of psychological disorders and symptoms with the use of a structured diagnostic interview and self-report measures, and examined patient-reported mental health service utilization and barriers to care.
Waitlisted liver transplant candidates (N = 120) completed assessments during routine clinic appointments at a single time point.
Participants endorsed moderate-to-severe levels of depression (19.2%), anxiety (26.7%), and Post Traumatic Stress Disorder (PTSD) (23.3%). Forty-three percent had received some form of mental health treatment in the recent past, and a range of barriers to accessing mental health services were endorsed. In a subset of 39 participants who received a structure diagnostic assessment, there was a high prevalence of current (51.3%) and past (82.1%) psychiatric disorders. Elevated scores on depression, anxiety, and PTSD measures were associated with significant decrements in health-related quality of life, but were not differentially associated with mental health service utilization.
There are a significant number of end-stage liver disease patients who could benefit from intervention who are not currently connected to treatment. Many patients do not see the need for accessing services, perhaps because of a lack of insight or knowledge about the benefits of mental health treatment. Future research should determine optimal treatment and service delivery methods for this vulnerable population.