Abnormal Illness Behavior, Alexithymia, Demoralization, and Other Clinically Relevant Psychosocial Syndromes in Kidney Transplant Recipients: A Comparative Study of the Diagnostic Criteria for Psychosomatic Research System versus ICD-10 Psychiatric Nosology

Background: An average of 35% prevalence of psychiatric comorbidity has been reported in kidney transplant recipients (KTRs). However a higher prevalence of other psychosocial syndromes by using the Diagnostic Criteria for Psychosomatic Research (DCPR) was found in medically ill patients. No data on the DCPR are available in KTRs. Aims: To expand the information for sub-typing medical patients by using the DCPR and analyze the relationship with physical, psychological symptoms and daily-life problems in KTRs. Methods: 134 consecutive KTRs were administered the DCPR Interview and the MINI International Neuropsychiatric Interview 6.0. Results: 63.4% patients met the criteria for at least one DCPR diagnosis, of whom 32.1% with one DCPR diagnosis (DCPR=1), and 31.3% more than one (DCPR>1), especially Abnormal Illness behaviour (26.1%), Irritability (31.3%), alexithymia (23.1%) and Demoralization (17.2%). Forty-six patients (34.3%) met the criteria for an ICD diagnosis. Among patients without an ICD-10 diagnosis, 47.7% had at least one DCPR syndrome (p <0.001). Conclusions: A high prevalence of DCPR diagnoses was found in KTRs, including those who resulted to be ICD-10 non-cases. The joint use of DCPR should be part of a correct psychosocial assessment of KTRs.