[Psychological disorders encountered during the post-transplantation period of bone marrow]

Psychological issues encountered during the procedure of a bone marrow transplantation (BMT) have already been described. Anxiety, depressive behaviour and anger are reactions usually observed. For inpatients, the psychological status seems to follow the somatic status. Among patients with a kidney transplant, some authors have observed psychological problems related to the patient's impression of acquiring some of the donor's characteristics through the graft. Little is known about psychological issues following bone marrow transplantation, which requires a donor in the case of allogeneic transplantation. Thirty-nine patients (12 auto, 27 allogeneic) are included in this study. Patients had been undergoing BMT for six to eighteen months at the time of the study. All patients were in complete remission of their disease. To conduct our study, we used interviews, a rating scale of depression and anxiety, vocabulary testing, and a Rotter's scale. The patients were not suffering specifically from depression or anxiety. After BMT, they experienced both objective and subjective changes in their way of life. The majority appear to be well adapted to their new situation, and some patients have received some benefit from their experience. For a minority, the transplantation was disruptive. Psychological problems encountered in such cases were related to the personality and personal history of the patients. After an allogeneic BMT, some patients approached, by means of a complaint or a joke, the theme of transformation induced by the transplanted marrow. This suggests that psychological integration of an allogeneic marrow transplant is a complex procedure. The various components of this elaboration could be studied further by using more sophisticated means to analyse interviews.