Medically Induced Exacerbation of PTSD Following Lung Transplantation: A Case Series

Abstract

Posttraumatic stress disorder (PTSD) occurs at double the rate in individuals undergoing lung transplantation, compared to the normal population. The psychological sequela of PTSD makes recovery more challenging and may result in poor medical and psychological outcomes. A series of three cases illustrate this presentation. In all cases, PTSD history and symptomatology was undisclosed prior to lung transplantation, despite robust psychological evaluation. All patients experienced traumatic delirium during the acute recovery phase from transplantation. Re-emergence and exacerbation of PTSD symptoms related to remote trauma lasting up to 2 years after transplant. Noncompliance with post-transplant recovery occurred in the sample of cases presented. Major surgeries, such as lung transplant may exacerbate premorbid PTSD possibly via psychological sequela such as delirium, regardless of type or remoteness of trauma experiences. Existing psychological evaluation practices may not be adequate to capture PTSD as many patients may fail to disclose relevant history. Novel evaluation and treatment methods need to be developed.