Affective status in liver transplant recipients as a function of self-perception of general health.

Objective: We aimed to determine whether there were differences with regard to anxiety and depressive symptomatology between liver transplant recipients with better (G(1)) versus worse (G(2)) self-perceptions of general health compared with pre-liver transplantation cirrhotic patients (G(3)).

Methods: The groups of patients included 168 recipients including 85 and 83 with better or worse self-perceptions of general health, respectively, and 75 cirrhotic pre-liver transplantation patients. For the psychological assessment we used the Hospital Anxiety and Depression Scale and the general health dimension of the SF-36 Health Questionnaire. The following analyses were used: Analysis of variance (ANOVA) with post hoc pairwise comparisons by means of Tukey's test and Cohen's d, an effect size index.

Results: Significant differences were observed among the three groups for the variables of anxiety (P = .000) and depression (P = .000). Specifically, liver transplant recipients with better self-perceptions of general health displayed lower scores (better mental health) compared with those showing worse self-perceptions or cirrhotic patients. There were no differences between the latter two groups. The differences in these variables were relevant (large effect sizes) for anxiety (Cohen's d(1-2) = -1.075, Cohen's d(1-3) = -1.155) and for depression (Cohen's d(1-2) = -1.145, Cohen's d(1-3) = -1.158).

Conclusions: The anxious-depressive status was not necessarily better among liver transplant recipients. There was great variability among them as a function of self-perceived general health. Transplant recipients with worse self-perception of general health presented the same anxiety-depressive levels as patients with severe liver disease in the pretransplantation phase; the latter groups reach the clinical threshold on the depression scale.