Clinical Research on Psychiatric Problems of Cutting-Edge Medicine :

我们于1999年至2001年进行了为期三年的关于尖端医学精神问题的临床研究。研究对象是接受尖端医学治疗的患者，如一对接受器官移植的受者和他们的活体供者。此外，我们使用捐赠者的家庭作为受试者。我们也以接受透析治疗的终末期肾衰竭患者为研究对象，进行精神病学访谈。精神病诊断采用DSM-IV精神病标准。此外，我们亦使用不同的心理问卷来评估他们的心理状况及生活质量，结果如下。活体肝移植后3个月内，成人受者的精神障碍患病率超过50%。精神障碍以谵妄和重性抑郁为主。谵妄是指术后谵妄。重性抑郁症表现为一种矛盾的形式，即尽管移植后结局良好，但仍有抑郁症状。在精神病理学方面，反常抑郁与受试者心理内疚感的存在密切相关。相反，捐赠者和儿童接受者的精神疾病患病率非常低。在肾移植中也获得了相同的结果。然而，活体供肾移植的患病率低于活体供肝移植。随着移植后时间的延长，精神疾病的患病率也随之降低。但是，我们要检查他们的精神和心理状况，因为我们的调查时间只有3年。

We performed clinical research on psychiatric problems of cutting-edge medicine for three years from 1999 to 2001.The subjects were patients who receive cutting-edge medicine such as a pair of the recipient who underwent organ transplantation and their living donor. Moreover, we used donors' families as the subjects. We also use patients with end-stage renal failure on dialysis therapy as the subjects.We performed psychiatric interviews for the subjects. The psychiatric diagnosis was done using the DSM-IV psychiatric criteria. In addition, we administered various psychological questionnaires in order to assess their psychological aspects and QOL aspects.The results were as follows. The prevalence rate of psychiatric disorders was more than 50% in adult recipients within three months following living donor liver transplantation. The main psychiatric disorders were delirium and major depression. The delirium means postoperative delirium. Major depression was manifested in a paradoxical form which refers to depressive symptoms in spite of favorable outcome after transplantation. As for psychopathological aspects, the paradoxical depression was closely related to the existence of guilt feelings in the recipients' mind. On the contrary, the prevalence rates of psychiatric disorders were very low in the donors and child recipients. The same results were obtained in kidney transplantation. However, the prevalence rate was lower for living donor Kidney transplantation than for living donor liver transplantation. As the duration after transplantation was longer, the prevalence rate of psychiatric disorders was lower. However, we have to examine their psychiatric and psychological conditions since the period of our investigation was only for three years.