Page 35 - JCBP-2-3

Journal of Clinical and
Basic Psychosomatics Organ donation after euthanasia

those with neurodegenerative or psychiatric diseases. The psychiatric disorder such as post-traumatic stress disorder,
combined procedure, guided by national ODE protocols, obsessive-compulsive disorder, or psychosis. 3,4
enables the donation of organs such as kidneys, lungs, and Tinnitus is defined as “the phantom perception of
hearts. Annually, the incidence of ODE increases, with sound without the corresponding acoustic or mechanical
cases based on psychiatric suffering accounting for up to correlates in the cochlea.” It can be attributable to hearing
50% of all ODE cases, reflecting its growing acceptance loss, somatosensory system dysfunction, or auditory
and implementation.
cortex dysfunction. Among these, hearing loss is the most
The case series conducted by van Dijk et al. marked common cause, scarcely accompanied by underlying
1
the first scientific insight into organ donation after severe pathologies . Therefore, tinnitus is primarily viewed
5
euthanasia (ODE) among psychiatric patients. In this case as a prevalent ontological disorder. In 2023, Hackenberg
series covering the first 10 years of ODE in psychiatric et al. revealed a prevalence of 26.1% among the German
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patients, it was revealed that some patients presented adult population, consistent with diverse prevalence rates
with both psychiatric and somatic disorders. Somatoform reported in the literature: 9 – 29% in Europe and 4 – 37%
complaints were not primarily documented as a psychiatric globally.
disease, leading to a debate over whether some patients’
suffering should be classified as psychiatric or somatic. However, tinnitus commonly co-occurs with psychiatric
7
Unfortunately, detailed specifics about the psychiatric comorbidities, particularly anxiety and depression. The
8
disorders, treatment attempts, and the duration of both systematic review by Salazar et al. included 28 studies
disorders and treatments were partly unavailable to the that reported a mean depression prevalence of 33% (range
6 – 84%), consistent with findings by Meijers et al., who
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researchers. In addition, some details were deliberately reported rates between 4.6 and 41.7%. The wide range
withheld to protect the privacy of individual patients,
curtailing the granularity of the information. While of reported prevalence of depressive symptom scores is
classifying ODE patients based on their conditions using attributed to variations in questionnaires, definitions,
the available information was generally straightforward, and cut-off values used to measure and define depressive
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certain diseases posed challenges in categorization. symptoms. A 45% lifetime prevalence of anxiety disorders
While amyotrophic lateral sclerosis and myasthenia is reported among individuals with tinnitus. In addition,
gravis distinctly fall under somatic conditions, disorders significant overlap is suggested in the associated (sub)
like depression, post-traumatic stress disorder, and cortical brain areas and cortico-subcortical networks
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personality disorders are unquestionably psychiatric. involved in attention, distress, and memory functions.
However, the classification of tinnitus or chronic pain Genome-wide association studies have demonstrated the
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syndrome, which may manifest alone or alongside other polygenic nature of tinnitus susceptibility. Bhatt et al.
conditions, is less straightforward. This perspective revealed common genetic links between tinnitus and
article delves deeper into the classification challenges of neuropsychiatric disorders, with gene sets related to anxiety
these disorders in our ODE studies, exploring alternative and stress being significantly associated with tinnitus-
perspectives and discussing their clinical and research related distress. Psychological treatments, such as cognitive
implications. We aim to provide a more detailed behavioral therapy and eye movement desensitization and
description and exploration of a preliminary practical reprocessing, are effective for tinnitus patients, regardless
experience from previous research. of the disorder’s classification. 12,13
Comparably, chronic pain disorder involves
2. Different perspectives persistent and severe pain consuming the individual’s
At least two different perspectives on the relationship attention, leading to significant distress or impairment.
between tinnitus, chronic pain syndrome, and psychiatric Conventionally, pain in the absence of an apparent
disorders are evident. According to the Diagnostic and anatomical or neurophysiological cause was labeled
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Statistical Manual of Mental Disorders (DSM-5TR), the as psychopathological. However; Katz et al.
mentioned conditions fall under “somatic symptoms and described several unusual, clinically atypical, and
2
related disorders.” Such a somatic symptom disorder (SSD) previously unexplained physical phenomena for which
is characterized by one or more somatic symptoms, such as pathophysiological explanations have been found more
pain or phantom noise, accompanied by excessive thoughts, recently. Despite the absence of a uniform definition,
feelings, and/or behaviors causing significant distress and/ chronic pain affects one in five adults in Canada.
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or dysfunction, independent of any underlying medical Chronic pain may have a complex interplay with
condition. The second perspective suggests that pain or psychological factors and/or symptoms. The neural
perception of sounds may be symptoms of an underlying mechanisms underlying chronic pain are complex and

Volume 2 Issue 3 (2024) 2 doi: 10.36922/jcbp.3182