Chest
Clinical InvestigationsCOPDThe Psychological Impact of End-Stage Lung Disease
Section snippets
Subjects
Subjects consisted of 243 consecutively referred patients (of 259 potential patients) with a diagnosis of end-stage pulmonary disease who received a psychological assessment (including the MMPI-2) at one of two urban organ transplant centers as part of a pretransplant evaluation between 1993 and 1999. Demographic information is listed in Table 1. The specific medical diagnoses for the sample are presented in Table 2. One hundred sixty-nine patients were evaluated at Temple University Hospital,
Results
The mean MMPI-2 T scores for the entire sample are presented in Table 4. Consistent with prior research, mild mean elevations for the group as a whole were present on MMPI-2 scale 1 (hypochondriasis) and scale 3 (hysteria). Scale 1, scale 2 (depression), and scale 3 had the highest number of individuals scoring above the cutoff of 65T.
Profile clusters were examined for each contributing transplant center and as an aggregate with similar results: a five-group solution best characterized the
Discussion
Five distinct personality profiles, each with the potential to impact treatment decisions and quality of life, were elucidated via cluster analysis of a standardized personality test given to a large sample of transplant candidates suffering from end-stage lung disease. As with prior research, nearly one third of the patients produced profiles indicating clinically significant psychopathology as indicated by prominent elevations of single or multiple MMPI-2 scales. One-half of the patients with
Conclusion
The present study elucidated five different psychological styles of coping with end-stage lung disease that may affect quality of life, interactions with the pulmonary treatment team, and the need for ancillary psychiatric interventions. How these individuals express physical and psychological distress, along with the necessity of mental health intervention, needs to be considered during the evaluation of patients with end-stage lung disease. Further research is suggested to replicate these
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2011, Primary Care - Clinics in Office PracticeCitation Excerpt :This result suggests that health-related quality of life is influenced by psychological symptoms as well as by physical limitations. Lung disease has a greater negative impact on life satisfaction than most systemic conditions,7 and this is particularly true for patients with end-stage COPD. Depression is common in patients with advanced COPD, though it can be unrecognized8 and undertreated.