慢性疾病中的心智化：移植受者反思功能和依从性的横断面研究。

IF 3.3 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research Pub Date : 2025-10-03 DOI:10.1016/j.jpsychores.2025.112399

Benedetta Muzii , Giorgia Margherita

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引用次数: 0

摘要

背景：实体器官移植给受者带来了巨大的心理挑战。虽然研究已经建立了心理困扰和药物依从性之间的关系，但在移植人群中，心理化的潜在保护作用仍未被探索。这项初步研究调查了在移植受者中，反射功能是否调节了精神病理症状和药物依从性之间的关系。方法：对117例成人实体器官移植受者（肾脏57.3%，肝脏25.6%，心脏11.1%，肺3.4%，多器官2.6%）进行横断面研究。参与者完成了评估反思功能、医疗依从性、精神病理症状、感知社会支持和健康相关生活质量的有效测量。分层多元回归分析检验了提出的调节模型，控制了相关的人口统计学和临床变量。结果：精神病理学负向预测药物依从性，而反思功能与依从性行为呈显著正相关。精神病理和反思功能之间的相互作用是显著的，表明精神病理症状和依从性之间的有害关系在反思功能受损时显著增强，而在反思功能高水平时不显著。结论：这些研究结果表明，在移植受者的心理困扰期间，心理化可以作为一种心理缓冲来对抗不依从性。反射功能受损是药物不依从性的一个特定风险因素，特别是当接受者经历精神病理症状升高时。结果支持以心理为基础的干预措施的发展，以增强移植受者对移植经历的心理整合，并促进免疫抑制治疗的持续坚持。

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Mentalizing in chronic conditions: A cross-sectional study of reflective functioning and adherence in transplant recipients

Background

Solid organ transplantation presents significant psychological challenges for recipients. While research has established relationships between psychological distress and medication non-adherence, the potential protective role of mentalization remains unexplored in transplant populations. This pilot study investigated whether reflective functioning moderates the relationship between psychopathological symptoms and medication adherence in transplant recipients.

Methods

This cross-sectional study examined 117 adult solid organ transplant recipients (kidney 57.3 %, liver 25.6 %, heart 11.1 %, lung 3.4 %, multiple organs 2.6 %). Participants completed validated measures assessing reflective functioning, medical adherence, psychopathological symptoms, perceived social support, and health-related quality of life. Hierarchical multiple regression analyses tested the proposed moderation model, controlling relevant demographic and clinical variables.

Results

Psychopathology negatively predicted medication adherence, while reflective functioning demonstrated a significant positive association with adherence behaviors. The interaction between psychopathology and reflective functioning was significant, indicating that the deleterious relationship between psychopathological symptoms and adherence was significantly stronger when reflective functioning was impaired but non-significant at high levels of reflective functioning.

Conclusions

These findings demonstrate that mentalization functions as a psychological buffer against non-adherence during periods of psychological distress in transplant recipients. Impaired reflective functioning represents a specific risk factor for medication non-adherence, particularly when recipients experience elevated psychopathological symptoms. Results support the development of mentalization-based interventions to enhance transplant recipients' psychological integration of the transplant experience and promote sustained adherence to immunosuppressive therapy.

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来源期刊

Journal of Psychosomatic Research 医学-精神病学

CiteScore

7.40

自引率

6.40%

发文量

314

审稿时长

6.2 weeks

期刊介绍： The Journal of Psychosomatic Research is a multidisciplinary research journal covering all aspects of the relationships between psychology and medicine. The scope is broad and ranges from basic human biological and psychological research to evaluations of treatment and services. Papers will normally be concerned with illness or patients rather than studies of healthy populations. Studies concerning special populations, such as the elderly and children and adolescents, are welcome. In addition to peer-reviewed original papers, the journal publishes editorials, reviews, and other papers related to the journal''s aims.