Published online June 1, 2005
PEDIATRICS Vol. 115 No. 6 June 2005, pp. 1640-1644 (doi:10.1542/10.1542/peds.2004-0118)
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Traumatic Stress Symptoms in Adolescent Organ Transplant Recipients

Lisa Libman Mintzer, PhD*, Margaret L. Stuber, MD{ddagger}, Debra Seacord, PhD{ddagger}, Marleen Castaneda, BA{ddagger}, Violet Mesrkhani, MA{ddagger} and Dorie Glover, PhD{ddagger}

* Division of Child and Adolescent Psychiatry, Department of Psychiatry and Biobehavioral Science, Neuropsychiatric Institute, University of California, Los Angeles, California
{ddagger} Behavioral Sciences Department, La Rabida Children’s Hospital, Chicago, Illinois

Objective. Symptoms of posttraumatic stress disorder (PTSD) after life-threatening medical illness have been found to predict poor outcome in preliminary studies of adults and children. However, these symptoms are rarely recognized in general medical or pediatric settings. Here we report on the first large investigation to assess prevalence and correlates of self-reported symptoms of posttraumatic stress in a nonreferred sample of adolescent liver, heart, and kidney transplant recipients.

Methods. One hundred four adolescents, ages 12 to 20 years (mean: 15.7; SD: 2.1), completed and returned the University of California, Los Angeles, PTSD Index for the Diagnostic and Statistical Manual of Mental Disorders. All participants were at least 1 year post-initial transplant and were fluent speakers of English and/or Spanish.

Results. More than 16% of the adolescents met all symptom criteria for PTSD, and an additional 14.4% met 2 of 3 symptom-cluster criteria. Regression analysis indicated no effect of gender, ethnicity, age at interview, organ type, time since transplant, or age at transplant.

Conclusions. As has been found with other life-threatening pediatric conditions, solid organ transplantation can precipitate symptoms of posttraumatic stress. Symptoms are not predicted by what would be considered objective factors increasing life threat, suggesting a greater salience of subjective appraisal of threat, as has been seen in studies of childhood cancer survivors.

Key Words: transplant • psychological impact • PTSD • adolescents • Hispanic American

Abbreviations: PTSD, posttraumatic stress disorder • UCLA, University of California, Los Angeles • DSM, Diagnostic Statistical Manual • OR, odds ratio

Accepted Jan 20, 2005.


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