Psychiatric aspects of lung transplant. The Toronto Lung Transplant Group.

Psychiatric problems in a consecutive series of lung transplant applicants (n = 116), candidates (n = 57) and recipients (n = 42) are reported. Fifty percent of all the applicants for lung transplantation reported a history of psychiatric disorder including organic brain syndrome (19%), major depressive episode (16%), panic or anxiety disorder not otherwise specified (11%) and alcohol or substance abuse (11%). In most cases, psychiatric problems had occurred in these patients as a complication of endstage lung disease. The most common new diagnoses in candidates awaiting surgery were adjustment disorder with anxious mood and anxiety disorders. Organic brain syndromes developed in over 50% of the recipients during the first two post-operative weeks. The type and prevalence of these disorders have implications for the management of lung transplant patients and those with chronic pulmonary disease.