After
liver transplantation, recipients often experience psychological problems that are influenced by demographic, personal, and transplant-related variables. However, because previous studies have mostly reported on psychological problems and their influencing factors in the first years after
transplantation, less is known about their prevalence and influence in the long run. The aims of this study were to examine point-prevalence rates of symptoms of anxiety, depression, and posttraumatic stress (PTS) at different time periods after
transplantation and to examine the transplant-related variables associated with these problems. A cross-sectional survey was performed among 373
liver transplant recipients who received transplants between 1979 and 2009 at our center. Five clinically relevant time periods were identified: 0.5 to <2 years, 2 to <5 years, 5 to <10 years, 10 to <15 years, and ≥15 years after
transplantation. The response rate was 75% (n=281). Overall, 33.4% of the respondents experienced clinically relevant symptom levels of anxiety (28.7%), depression (16.5%), or PTS (10.0%). Symptoms of anxiety and depression were more prevalent in the first 2 years and in the long term after
transplantation. PTS symptoms were more prevalent in the first 5 years after
transplantation. However, the prevalence rates did not differ significantly between time periods. Viral
hepatitis and the number of side effects of the immunosuppressive (IS) medication were found to be associated with all psychological problems.
Alcoholic liver disease was associated with anxiety and depression in the short term after
transplantation. In conclusion, a significant subset of transplant recipients experience psychological problems, both shortly after
transplantation and in the long run. These problems are often associated with side effects from the IS medication. Therefore, the monitoring of psychological problems, the offering of psychological counseling, and the management of the medication's side effects should be part of the routine care of transplant recipients.