ICD-11 Adjustment Disorder among Organ Transplant Patients and Their Relatives
Abstract
:1. Introduction
1.1. Adjustment Disorder in ICD-11
1.2. Organ Transplantation, Related Stressors and Long-Term Mental Health
1.3. Relatives of Transplant Patients
1.4. Social Support in the Post-Transplant Context
2. Materials and Methods
2.1. Participants and Procedure
2.2. Measures
2.2.1. Adjustment Disorder
2.2.2. Posttraumatic Stress Disorder
2.2.3. Somatic Problems
2.2.4. Depression
2.2.5. Health-Related Quality of Life
2.2.6. Social Support
2.3. Data Analysis
3. Results
3.1. Prevalence and Clinical Characteristics of AD
3.2. Correlations of Study Variables
3.3. Predictors of AD in Patients and Relatives
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- Evans, S.C.; Reed, G.M.; Roberts, M.C.; Esparza, P.; Watts, A.D.; Ritchie, P.L.J.; Correia, J.M.; Saxena, S. Psychologists’ perspectives on the diagnostic classification of mental disorders: Results from the WHO-IUpsyS Global Survey. Int. J. Psychol. 2013, 48, 177–193. [Google Scholar] [CrossRef] [PubMed]
- Mitchell, A.J.; Chan, M.; Bhatti, H.; Halton, M.; Grassi, L.; Johansen, C.; Meader, N. Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: A meta-analysis of 94 interview-based studies. Lancet Oncol. 2011, 12, 160–174. [Google Scholar] [CrossRef]
- Silverstone, P.-H. Prevalence of psychiatric disorders in medical inpatients. J. Nerv. Ment. Dis. 1996, 184, 43–51. [Google Scholar] [CrossRef] [PubMed]
- WHO. International Classification of Diseases, 11th Revision; World Health Organisation: Geneva, Switzerland, 2018. [Google Scholar]
- Bachem, R.; Casey, P. Adjustment disorder: A diagnose whose time has come. J. Affect. Disord. 2018, 227, 243–253. [Google Scholar] [CrossRef] [PubMed]
- Maercker, A.; Brewin, C.R.; Bryant, R.A.; Cloitre, M.; Reed, G.M.; van Ommeren, M.; Humayun, A.; Jones, L.M.; Kagee, A.; Llosa, A.E.; et al. Proposals for mental disorders specifically associated with stress in the International Classification of Diseases-11. Lancet. 2013, 381, 1683–1685. [Google Scholar] [CrossRef]
- Köllner, V. Posttraumatische Belastungsstörungen bei körperlichen Erkrankungen und medizinischen Eingriffen. In Traumafolgestörungen, 5th ed.; Maercker, A., Ed.; Springer: Berlin, Germany, 2019; pp. 443–459. [Google Scholar] [CrossRef]
- Rothenhäusler, H.-B.; Ehrentraut, S.; Kapfhammer, H.-P.; Lang, C.; Zachoval, R.; Bilzer, M.; Schelling, G.; Gerbes, A.L. Psychiatric and psychosocial outcome of orthotopic liver transplantation. Psychother Psychosom. 2002, 71, 285–297. [Google Scholar] [CrossRef] [PubMed]
- Davydow, D.S.; Lease, E.D.; Reyes, J.D. Posttraumatic stress disorder in organ transplant recipients: A systematic review. Gen. Hosp. Psychiatry J. 2015, 37, 387–398. [Google Scholar] [CrossRef]
- Shelby, R.A.; Golden-Kreuz, D.M.; Anderson, B.L. PTSD diagnoses, subsyndromal symptoms, and comorbidieties contribute to impairments for breast cancer survivors. J. Trauma Stress. 2008, 21, 165–172. [Google Scholar] [CrossRef] [PubMed]
- Schroth, S.; Köllner, V. Anpassungsstörungen: Eine schwierige Diagnose. PSYCH up2date. 2018, 12, 399–409. [Google Scholar] [CrossRef]
- Maercker, A.; Einsle, F.; Kollner, V. Adjustment disorders as stress response syndromes: A new diagnostic concept and its exploration in a medical sample. Psychopathology 2007, 40, 135–146. [Google Scholar] [CrossRef]
- Jin, S.; Yan, L.; Xiang, B.; Wen, T.; Zhao, J.; Xu, M.; Yang, J. Posttraumatic stress disorder after liver transplantation. Hepatobiliary Pancreat Dis. Int. 2012, 11, 28–33. [Google Scholar] [CrossRef]
- Jacobs, J.; Michael, T.; Brandsch, S.L.; Schäfers, H.-J.; Wilkens, H.; Köllner, V. Prävalenz der posttraumatischen Belastungsstörung bei Patienten auf der Warteliste und nach einer Lungentransplantation [The prevalence of posttraumatic stress disorder in lung transplant candidates and recipients]. Psychother Psychosom Med. Psychol. 2015, 65, 255–260. [Google Scholar] [CrossRef] [PubMed]
- Davydow, D.S.; Gifford, J.M.; Desai, S.V.; Needham, D.M.; Bienvenu, O.J. Posttraumatic stress disorder in general intensive care unit survivors: A systematic review. Gen. Hosp. Psychiatry 2008, 30, 421–434. [Google Scholar] [CrossRef] [PubMed]
- Dew, M.A.; Kormos, R.L.; DiMartini, A.F.; Schwitzer, G.E.; Schulberg, H.C.; Roth, L.H.; Bartley, P.G. Prevalence and risk of depression and anxiety-related disorders during the first three years after heart transplantation. Psychosomatics 2001, 42, 300–313. [Google Scholar] [CrossRef] [PubMed]
- Hall, E.C.; Engels, E.A.; Pfeiffer, R.M.; Segev, D.L. Association of antibody induction immunosuppression with cancer after kidney transplantation. Transplantation 2015, 99, 1051–1057. [Google Scholar] [CrossRef] [PubMed]
- Fukunishi, I.; Sugawara, Y.; Takayama, T.; Makuuchi, M.; Kawarasaki, H.; Surman, O.S. Psychiatric disorders before and after living-related transplantation. Psychosomatics 2001, 42, 337–343. [Google Scholar] [CrossRef] [PubMed]
- Köllner, V.; Schade, I.; Maulhardt, T.; Maercker, A.; Joraschky, P.; Gulielmos, V. Posttraumatic stress disorder and quality of life after heart or lung transplantation. Transplant. Proc. 2002, 34, 2192–2193. [Google Scholar] [CrossRef]
- Cohen, D.G.; Christie, J.D.; Anderson, B.J.; Diamond, J.M.; Judy, R.P.; Shah, R.J.; Cantu, E.; Bellamy, S.L.; Blumenthal, N.P.; Demissie, E.; et al. Cognitive Ffunction, mental health, and health-related quality of life after lung transplantation. Ann. Am. Thorac. Soc. 2014, 11, 522–530. [Google Scholar] [CrossRef]
- Guimaro, M.S.; Lacerda, S.S.; Aguilar, M.R.; Karam, C.H.; Kernkraut, A.M. Post-traumatic stress disorders, mood disorders, and quality of life. Ann. Am. Thorac. Soc. 2014, 11, 187–188. [Google Scholar] [CrossRef]
- Favaro, A.; Gerosa, G.; Caforio, A.L.P.; Volpe, B.; Rupolo, G.; Zarneri, D.; Boscolo, S.; Pavan, C.; Tenconi, E.; Agostino, C.; et al. Posttraumatic stress disorder and depression in heart transplantation recipients: The relationship with outcome and adherence to medical treatment. Gen. Hosp. Psychiatry 2011, 33, 1–7. [Google Scholar] [CrossRef]
- Einsle, F.; Kraft, D.; Köllner, V. Post-traumatic stress disorder (PTSD) in cardiology and oncology—which diagnostic tools should be used? J. Psychosom Res. 2012, 72, 434–438. [Google Scholar] [CrossRef]
- Baranyi, A.; Krauseneck, T.; Rothenhäusler, H. Posttraumatic stress symptoms after solid-organ transplantation: Preoperative risk factors and the impact on health-related quality of life and life satisfaction. Health Qual. Life Outcomes 2013, 11, 1–10. [Google Scholar] [CrossRef] [PubMed]
- Yang, L.S.; Shan, L.L.; Saxena, A.; Morris, D.L. Liver transplantation: A systematic review of long-term quality of life. Liver Int. 2014, 34, 1298–1313. [Google Scholar] [CrossRef] [PubMed]
- Köllner, V.; Einsle, F.; Schade, I.; Maulhardt, T.; Gulielmos, V.; Joraschky, P. Psychosoziale Belastung und Lebensqualität bei Patienten nach Herz- oder Lungentransplantation [The influence of anxiety, depression and post traumatic stress disorder on quality of life after thoracic organ transplantation]. Z Psychosom Med. Psychother. 2003, 49, 262–274. [Google Scholar] [CrossRef]
- Dew, M.A.; Myaskovsky, L.; DiMartini, A.F.; Switzer, G.E.; Schulberg, H.C.; Kormos, R.L. Onset, timing and risk for depression and anxiety in family caregivers to heart transplant recipients. Psychol. Med. 2004, 34, 1065–1082. [Google Scholar] [CrossRef]
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed.; American Psychiatric Association: Washington, DC, USA, 2013. [Google Scholar]
- Stukas, A.A.; Dew, M.A.; Switzer, G.E.; DiMartini, A.; Kormos, R.; Griffith, B. PTSD in heart transplant recipients and their primary family caregivers. Psychosomatics 1999, 40, 212–221. [Google Scholar] [CrossRef]
- Northouse, L.L.; Katapodi, M.C.; Song, L.; Zhang, L.; Mood, D.W. Interventions with family caregivers of cancer patients: Meta-analysis of randomized trials. CA Cancer J. Clin. 2010, 60, 317–339. [Google Scholar] [CrossRef] [PubMed]
- Vitaliano, P.P.; Young, H.M.; Zhang, J. Is caregiving a risk factor for illness? Curr. Dir. Psychol. Sci. 2004, 13, 13–16. [Google Scholar] [CrossRef]
- Maercker, A.; Horn, A.B. A socio-interpersonal perspective on PTSD: The case for environments and interpersonal processes. Clin. Psychol Psychother. 2013, 20, 465–481. [Google Scholar] [CrossRef]
- Brewin, C.R.; Andrews, B.; Valentine, J.D. Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. J. Consult. Clin. Psychol. 2000, 68, 748–766. [Google Scholar] [CrossRef]
- Prati, G.; Pietrantoni, L. The relation of perceived and received social support to mental health among first responders: A meta-analytic review. J. Community Psychol. 2010, 38, 403–417. [Google Scholar] [CrossRef]
- Dew, M.A.; DiMartini, A.F.; DeVito Dabbs, A.J.; Fox, K.R.; Myaskovsky, L.; Posluszny, D.M.; Switzer, G.E.; Zomak, R.A.; Kormos, R.L.; Toyoda, Y. Onset and risk factors for anxiety and depression during the first 2 years after lung transplantation. Gen. Hosp. Psychiatry 2012, 34, 127–138. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Canning, R.D.; Dew, M.A.; Davidson, S. Psychological distress among caregivers to heart transplant recipients. Soc. Sci Med. 1996, 42, 599–608. [Google Scholar] [CrossRef]
- Lorenz, L.; Perkonigg, A.; Maercker, A. A socio-interpersonal approach to adjustment disorder: The example of involuntary job loss. Eur. J. Psychotraumatol. 2018, 9, 1425576. [Google Scholar] [CrossRef] [PubMed]
- Christie, J.D.; Edwards, L.B.; Kucheryavaya, A.Y.; Benden, C.; Dipchand, A.I.; Dobbels, F.; Kirk, R.; Rahmel, A.O.; Stehlik, J.; Hertz, M.I. The registry of the international society for heart and lung transplantation: 29th adult lung and heart-lung transplant report—2012. J. Hear. Lung Transplant. 2012, 31, 1073–1086. [Google Scholar] [CrossRef] [PubMed]
- Einsle, F.; Köllner, V.; Dannemann, S.; Maercker, A. Development and validation of a self-report for the assessment of adjustment disorders. Psychol Health Med. 2010, 15, 584–595. [Google Scholar] [CrossRef] [PubMed]
- Bachem, R.; Perkonigg, A.; Stein, D.J.; Maercker, A. Measuring the ICD-11 adjustment disorder concept: Validity and sensitivity to change of the Adjustment Disorder—New Module questionnaire in a clinical intervention study. Int. J. Methods Psychiatr. Res. 2016, 26, 1–9. [Google Scholar] [CrossRef]
- Lorenz, L.; Bachem, R.; Maercker, A. The Adjustment Disorder–New Module 20 as a screening instrument: Cluster analysis and cut-off values. Int. J. Occup. Environ. Med. 2016, 7, 215–222. [Google Scholar] [CrossRef]
- Glaesmer, H.; Romppel, M.; Brähler, E.; Hinz, A.; Maercker, A. Adjustment disorder as proposed for ICD-11: Dimensionality and symptom differentiation. Psychiatry Res. 2015, 229, 940–948. [Google Scholar] [CrossRef] [PubMed]
- Cloitre, M.; Shevlin, M.; Brewin, C.R.; Bisson, J.I.; Roberts, N.P.; Maercher, A.; Karatzias, T.; Hyland, P. The International Trauma Questionnaire: Development of a self-report measure of ICD-11 PTSD and complex PTSD. Acta Psychiatr. Scand. 2018, 138, 536–546. [Google Scholar] [CrossRef]
- Stein, D.J.; McLaughlin, K.A.; Koenen, K.C.; Atwoli, L.; Friedman, M.J.; Hill, E.D.; Maercker, A.; Petukhova, M.; Shahly, V.; Van Ommeren, M.; et al. DSM-5 and ICD-11 definitions of posttraumatic stress disorder: Investigating “narrow” and “broad” approaches. Depress. Anxiety 2014, 31, 494–505. [Google Scholar] [CrossRef] [PubMed]
- Bachem, R.; Maercker, A. Self-help interventions for adjustment disorder problems: A randomized waiting-list controlled study in a sample of burglary victims. Cogn. Behav. Ther. 2016, 45, 397–413. [Google Scholar] [CrossRef] [PubMed]
- Kroenke, K.; Spitzer, R.L.; Janet, B.W.; Williams, D. The PHQ-15: Validity of a new measure for evaluating the severity of somatic symptoms. Psychosom Med. 2002, 64, 258–266. [Google Scholar] [CrossRef] [PubMed]
- Kroenke, K.; Spitzer, R.L.; Williams, J.B.W.; Löwe, B. The patient health questionnaire somatic, anxiety, and depressive symptom scales: A systematic review. Gen. Hosp. Psychiatry 2010, 32, 345–359. [Google Scholar] [CrossRef] [PubMed]
- Kroenke, K.; Spitzer, R.L.; Williams, J.B.W. The PHQ-9. Validity of a brief depression severety measure. J. Gen. Intern. Med. 2016, 16, 606–613. [Google Scholar] [CrossRef] [PubMed]
- Cameron, I.M.; Crawford, J.R.; Lawton, K.; Reid, I.C. Psychometric comparison of PHQ-9 and HADS for measuring depression severity in primary care. Br. J. Gen. Pract. 2008, 58, 32–36. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Ware, J.E.; Kosinski, M.; Keller, S.D. A 12-Item Short-Form Health Survey: Construction of scales and preliminary tests of reliability and validity. Med. Care. 1996, 34, 220–233. [Google Scholar] [CrossRef] [PubMed]
- Lim, L.L.; Fisher, J.D. Use of the 12-item Short-Form (SF-12) Health Survey in an Australian heart and stroke population. Qual. Life Res. 1999, 8, 1–8. [Google Scholar] [CrossRef] [PubMed]
- Gandhi, S.K.; Salmon, J.W.; Zhao, S.Z.; Lumbert, B.L. Psychometric evaluation of the 12-Item Short-Form Health Survey ( SF-12 ) in osteoarthritis and rheumatoid arthritis clinical trials. Clin. Ther. 2001, 23, 1080–1098. [Google Scholar] [CrossRef]
- Kilpeläinen, K.; Aromaa, A. European Health Indicators: Development and Initial Implementation: Final Report of the ECHIM Project; Helsinki University Press: Helsinki, Finland, 2008. [Google Scholar]
- Dalgard, O.S.; Dowrick, C.D.; Lehtinen, V.; Vazquez-Barquero, J.L.; Casey, P.; Wilkinson, G.; Ayuso-Mateos, J.L.; Page, H.; Dunn, G. Negative life events, social support and gender difference in depression. A multinational community survey with data from the ODIN study. Soc. Psychiatry Psychiatr. Epidemiol. 2006, 41, 444–451. [Google Scholar] [CrossRef] [PubMed]
- Bøen, H.; Dalgard, O.S.; Bjertness, E. The importance of social support in the associations between psychological distress and somatic health problems and socio-economic factors among older adults living at home: A cross sectional study. BMC Geriatr. 2012, 12, 1–12. [Google Scholar] [CrossRef] [PubMed]
- Dempster, A.P.; Laird, N.M.; Rubin, D.B. Maximum likelihood from incomplete data via the EM algorithm. J. R Stat. Soc. Ser. B 1977, 39, 1–38. [Google Scholar] [CrossRef]
- Bunzel, B.; Laederach-Hofmann, K.; Wieselthaler, G.; Roethy, W. Mechanical circulatory support as a bridge to heart transplantation: What remains? Long-term emotional sequelae in patients and spouses. J. Hear. Lung Transplant. 2007, 26, 384–389. [Google Scholar] [CrossRef] [PubMed]
- Bunzel, B.; Laederach-Hofmann, K. Patients benefit—Partners suffer? The impact of heart transplantationon the partner relationship. Transpl. Int. 1999, 12, 33–41. [Google Scholar] [CrossRef] [PubMed]
- Hund, B.; Reuter, K.; Härter, M.; Brähler, E.; Faller, H.; Keller, M.; Schulz, H.; Wegscheider, K.; Weis, J.; Wittchen, H.U.; et al. Stressors, symptom profile, and predictors of adjustment disorder in cancer patients. Results from an epidemiological study with the Composite International Diagnostic Interview, adaptation for oncology (CIDI-O). Depress. Anxiety 2016, 33, 153–161. [Google Scholar] [CrossRef]
- Lorenz, L.; Perkonigg, A.; Maercker, A. The course of adjustment disorder following involuntary job loss and its predictors of latent change. Clin. Psychol. Sci. 2018, 6, 647–657. [Google Scholar] [CrossRef]
- Connidis, I.A.; McMullin, J.A. Sociological ambivalence and family ties: A critical perspective. J. Marriage Fam. 2002, 64, 558–567. [Google Scholar] [CrossRef]
- Pinquart, M.; Sörensen, S. Gender differences in caregiver stressors, social resources, and health: An updated meta-analysis. J. Gerontol. 2006, 61, 33–45. [Google Scholar] [CrossRef]
- Schurig, S.; Schäfers, H.J.; Einsle, F.; Bernardy, K.; Schmied, W.; Köllner, V. Emergency surgery vs. elective surgery? Psychopathology after elective or emergency aortic arch replacement. Conf. Abstr. 2010, 68, 665–666. [Google Scholar]
- O’Donnell, M.L.; Alkemade, N.; Creamer, M.; McFarlane, A.C.; Silove, D.; Bryant, R.A.; Felmingham, K.; Steel, Z.; Forbes, D. A longitudinal study of adjustment disorder after trauma exposure. Am. J. Psychiatry 2016, 173, 1231–1238. [Google Scholar] [CrossRef]
- Or, R.; Kartal, A. Influence of caregiver burden on well-being of family member caregivers of older adults. Psychogeriatrics 2019. [Google Scholar] [CrossRef] [PubMed]
- Tix, A.P.; Frazier, P.A. The Use of Religious Coping During Stressful Life Events. J. Consult. Clin. Psychol. 1998, 66, 411–422. [Google Scholar] [CrossRef] [PubMed]
- Lorenz, L.; Doherty, A.; Casey, P. The role of religion in buffering the impact of stressful life events on depressive symptoms in patients with depressive episodes or adjustment disorder. Int. J. Environ. Res. Public Health 2019, 16, 1238. [Google Scholar] [CrossRef] [PubMed]
- Forstmeier, S. Lebensrückblick bei Anpassungsproblemen und Lebenskrisen. In Der Lebensrückblick in Therapie Und Beratung; Maercker, A., Forstmeier, S., Eds.; Springer: Berlin, Germany, 2013; pp. 85–105. [Google Scholar]
Age (Years): M (SD) Range | Patients (n = 140) | Relatives (n = 140) | |||
---|---|---|---|---|---|
54.16 (16.07) 16–82 | 57.53 (11.49) 24–80 | ||||
n | % | n | % | ||
Age group | <50 | 48 | 34.3 | 29 | 20.7 |
50 to 65 | 52 | 37.1 | 71 | 50.7 | |
>65 | 39 | 27.9 | 35 | 25.0 | |
missing | 1 | 0.7 | 5 | 3.6 | |
Sex | Women | 65 | 46.4 | 88 | 62.9 |
Men | 74 | 52.9 | 51 | 36.4 | |
Missing | 1 | 0.7 | 1 | 0.7 | |
Employment | Employed | 37 | 26.5 | 64 | 45.8 |
Self-employed | 9 | 6.4 | 12 | 8.6 | |
Homemaker | 4 | 2.9 | 8 | 5.7 | |
Student | 9 | 6.4 | |||
Retired | 75 | 53.6 | 51 | 36.4 | |
Unemployed | 2 | 1.4 | 3 | 2.1 | |
Other | 3 | 2.1 | 2 | 1.4 | |
Missing | 1 | 0.7 | |||
Education | Junior High | 24 | 17.1 | 31 | 22.1 |
High School | 70 | 50.0 | 72 | 51.4 | |
College | 43 | 30.7 | 36 | 25.7 | |
Other | 3 | 2.1 | 1 | 0.7 | |
Organ transplant * | Liver | 23 | 16.4 | ||
Lung | 49 | 35.0 | |||
Kidney | 26 | 18.6 | |||
Heart | 49 | 35.0 | |||
Time since transplantation (years) | 13.5 | ||||
Relationship with patient | Partner | 102 | 72.9 | ||
Parent | 25 | 17.9 | |||
Child | 9 | 6.4 | |||
Other | 3 | 2.1 | |||
Missing | 1 | 0.7 |
Measure | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 |
---|---|---|---|---|---|---|---|---|---|---|---|
M (SD) | 31.60 (13.10) | 32.31 (13.39) | 7.12 (1.92) | 7.45 (2.39) | 161.29 (109.69) | 54.1 (16.07) | 57.5 (11.59) | 7.77 (5.31) | 46.21 (10.45) | 9.56 (2.13) | 9.31 (2.15) |
1. Adjustment disorder, pat. | - | ||||||||||
2. Adjustment disorder, rel. | 0.27 ** | - | |||||||||
3. PTSD, pat. | 0.66 ** | 0.20 | - | ||||||||
4. PTSD, rel. | 0.20 * | 0.71 ** | 0.11 | - | |||||||
5. Time since transplantation | 0.03 | 0.09 | −0.01 | −0.01 | - | ||||||
6. Age, patient | 0.01 | −0.02 | −0.09 | −0.03 | 0.14 | - | |||||
7. Age, relative | 0.11 | 0.12 | −0.07 | 0.04 | 0.24 ** | 0.51 *** | - | ||||
8. Somatic problems, pat. | 0.62 *** | 0.17 * | 0.43 ** | 0.18 * | 0.14 | 0.15 | 0.06 | - | |||
9. Physical life quality, pat. | −0.43 *** | −0.20 * | −0.25 ** | −0.20 * | −0.08 | −0.40 *** | −0.31 | −0.58 *** | - | ||
10. Social support, pat. | −0.23 *** | −0.17 * | −0.26 ** | −0.02 | −0.21 * | −0.01 | 0.01 | −0.32 *** | 0.12 | - | |
11. Social support, rel. | −0.15 | −0.39 ** | −0.10 | −0.24 ** | −0.03 | 0.03 | 0.04 | −0.18 * | 0.04 | 0.39 *** | - |
b | se | β | t | p | R²ᶺ | Fᶺ | Pᶺ | |
---|---|---|---|---|---|---|---|---|
Step 1 | ||||||||
Gender | −0.642 ** | 0.235 | −0.253 ** | −2.732 | 0.007 | |||
Age | 0.037 | 0.070 | 0.047 | 0.5326 | 0.600 | |||
Time since transplantation | 0.006 | 0.010 | 0.056 | 0.619 | 0.537 | |||
Type of organ | 2.174 * | 1.025 | 0.191 * | 2.121 | 0.036 | 0.00 | 2.640 * | 0.037 |
Step 2 | ||||||||
Gender | −3.790 * | 1.865 | −0.149 * | −2.033 | 0.044 | |||
Age | −0.073 | 0.061 | −0.094 | −1.200 | 0.233 | |||
Time since transplantation | −0.005 | 0.008 | −0.039 | −0.546 | 0.586 | |||
Type of organ | 1.730 * | 0.840 | 0.152 * | 2.153 | 0.033 | |||
Somatic problems | 1.320 *** | 0.202 | 0.562 *** | 6.538 | 0.000 | |||
Physical life quality | −0.134 | 0.111 | −0.112 | −1.211 | 0.228 | 0.366 | 39.050 *** | 0.000 |
Step 3 | ||||||||
Gender | −3.338 ^ | 1.866 | −0.131 ^ | −1.789 | 0.076 | |||
Age | −0.070 | 0.060 | −0.091 | −1.172 | 0.244 | |||
Time since transplantation | −0.008 | 0.008 | −0.067 | −0.919 | 0.360 | |||
Type of organ | 1.718 | 0.796 | 0.151 | 2.157 | 0.033 | |||
Somatic problems | 1.216 *** | 0.209 | 0.518 *** | 5.829 | 0.000 | |||
Physical life quality | −0.151 | 0.110 | −0.126 | −1.373 | 0.172 | |||
Social support | −0.783 ^ | 0.443 | −0.131 ^ | −1.768 | 0.080 | 0.014 | 3.127 ^ | 0.080 |
b | se | β | t | p | R²ᶺ | Fᶺ | Pᶺ | |
---|---|---|---|---|---|---|---|---|
Step 1 | ||||||||
Gender | −4.587 ^ | 2.337 | −0.176 ^ | −1.962 | 0.052 | |||
Age | 0.163 | 0.098 | 0.151 | 1.655 | 0.101 | |||
Time since transplantation | 0.001 | 0.011 | 0.006 | 0.063 | 0.950 | 0.056 | 2.406 ^ | 0.071 |
Step 2 | ||||||||
Gender | −5.367 * | 2.320 | −0.026 * | −2.314 | 0.022 | |||
Age | 0.114 | 0.103 | 0.105 | 1.105 | 0.271 | |||
Time since transplantation | -0.002 | 0.011 | −0.018 | −0.199 | 0.843 | |||
Somatic problems | 0.293 | 0.253 | 0.125 | 1.158 | 0.249 | |||
Physical life quality | −0.555 | 0.136 | −0.128 | −1.142 | 0.256 | 0.046 | 3.100 * | 0.049 |
Step 3 | ||||||||
Gender | −6.853 ** | 2.123 | −0.263 ** | −3.288 | 0.002 | |||
Age | 0.129 | 0.093 | 0.120 | 1.383 | 0.169 | |||
Time since transplantation | −0.003 | 0.010 | −0.026 | −0.304 | 0.761 | |||
Somatic problems | 0.068 | 0.233 | 0.037 | 0.370 | 0.712 | |||
Physical life quality | −0.186 | 0.123 | −0.153 | −1.507 | 0.135 | |||
Social support | −2.421 *** | 0.466 | −0.491 *** | −5.190 | 0.000 | 0.166 | 26.940 *** | 0.000 |
© 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Bachem, R.; Baumann, J.; Köllner, V. ICD-11 Adjustment Disorder among Organ Transplant Patients and Their Relatives. Int. J. Environ. Res. Public Health 2019, 16, 3030. https://doi.org/10.3390/ijerph16173030
Bachem R, Baumann J, Köllner V. ICD-11 Adjustment Disorder among Organ Transplant Patients and Their Relatives. International Journal of Environmental Research and Public Health. 2019; 16(17):3030. https://doi.org/10.3390/ijerph16173030
Chicago/Turabian StyleBachem, Rahel, Jan Baumann, and Volker Köllner. 2019. "ICD-11 Adjustment Disorder among Organ Transplant Patients and Their Relatives" International Journal of Environmental Research and Public Health 16, no. 17: 3030. https://doi.org/10.3390/ijerph16173030