Increased incidence of anxiety and depression during bone marrow transplantation

Since the first organ transplantation in the 1950s, there have been reports that patients who underwent organ transplantation had a poor prognosis if they were depressed and/or anxious prior to transplantation. Our objective in this study was to determine the prevalence of anxiety and depression in the different stages of bone marrow transplantation (BMT).

Mood disorders (MD), anxiety disorders (AD), and adjustment disorders (ADD) were measured five times with DSM IV. The Beck Inventory of Depression (BID) and Hamilton Rating Scale of Anxiety (HRSA) were used to measure levels of depression and anxiety, respectively, at registration and at days -1, +21 +/- 7, +30 +/- 10, and 90 +/- 10 days from BMT. Analysis between diverse periods was made for allogeneic BMT (allo-BMT) with chi square test, while Fisher exact test was used for the autologous BMT (auto-BMT).

We report on 26 patients, including 18 with allo-BMT, and eight with auto-BMT. The allo-BMT was associated with depression during post BMT period (chi(2) = 11.924; p = 0.01). Slight anxiety without statistical significance was found in all stages. There was a high prevalence of anxiety and adjustment disorder in the immediate posttransplantation stage. Anxiety and adjustment disorders were more frequently found in all posttransplantation stages, particularly in the immediate stage (chi(2) =11.104, p = 0.02). After 3 months, no survivor received a psychiatric diagnosis. We did not find any differences in MD. There were five deaths.

The auto-BMT group did not show significant associations between different stages and psychiatric variables studied. One death occurred at 1 month. This patient had severe depression. We recommend that the depressive syndrome be intentionally researched during the different stages of BMT, specifically in the immediate transplantation stage.