Prevalence of mental disorders in a German kidney transplant population – results of a KTx360°-substudy

Objective: Studies show that patients with chronic diseases are disproportionately affected by mental disorders. An increased rate of affective disorders and anxiety disorders has also been demonstrated in patients after kidney transplantation (KTx). Repeatedly, a relationship between mental comorbidity and nonadherence to immunosuppressive medication has been reported. An important limitation must be observed: In most studies the mental disorders were diagnosed based on questionnaires. However, structured interviews represent the gold standard for diagnosing mental disorders. Methods: As part of the structured multimodal follow-up program (KTx360°), 726 patients after KTx were examined between May 2017 and July 2019. The structured diagnosis of mental disorders was performed in a diagnostic interview using the Mini-Dips. Results: The mean age of the participants was 52.6 (SD 14.3) years and 58.5% were men. In this group, 27.5% had a mental illness at the time of the diagnostic interview and the lifetime prevalence was 49.2%. The most common mental disorders were affective disorder, anxiety disorder, and adjustment disorder. Current mental illness was associated with lower age, female gender, increased depression and anxiety scores, and lower perceived social support. No association was found with self-reported adherence to immunosuppressive medication. Of patients with current mental illness, only 14.5% were currently under treatment. Conclusion: Patients after KTx showed a point and lifetime prevalence of mental disorders comparable to the German general population. There is a need to identify mental illness in patients after KTx, to be able to offer specialist treatment to a larger proportion of affected patients.