Psychiatric consultation for post-liver-transplantation patients.
OBJECTIVE
This report describes the clinical characteristics of referral inpatients who received liver transplantation and the surgeon's concordance with the psychiatric consultation.


METHODS
During a 4-year period, psychiatric consultation was arranged for 30 post-liver-transplantation inpatients at Kaohsiung Chang Gung Memorial Hospital. A psychiatrist assessed these patients and made psychiatric diagnoses according to the Diagnostic and Statistical Manual, 4th edition. The clinical data were routinely collected via modified MICRO-CARES software. At the end of the 4-year study period, all the medical records of these 30 inpatients were reviewed.


RESULTS
Psychiatric diagnosis was made in 70% of the patients (n = 21) in three major categories, including delirious state (n = 8), depressive disorder (n = 5), and anxiety/dyssomnia (n = 8). All these conditions were improved by psychiatric management. We found that the consultee's concordance with recommended drug prescriptions was high with antidepressants in depressive patients and low with antipsychotics in patients with delirium. Moreover, anxiolytics were frequently prescribed in post-transplant inpatients before psychiatric consultation.


CONCLUSIONS
These findings suggest that psychiatric consultation is beneficial to inpatients after liver transplantation, especially those with depression and delirium.
Chiu
Nien-Mu
NM
Department of Psychiatry, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan. neinmuch@cgmh.org.tw
Chen
Chao-Long
CL
Cheng
Andrew T A
AT
D000328:Adult; D000368:Aged; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003693:Delirium / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D020920:Dyssomnias / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D006760:Hospitalization; D006801:Humans; D016031:Liver Transplantation / Q000523:psychology*; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D008875:Middle Aged; D011567:Psychiatric Department, Hospital / Q000706:statistics & numerical data*; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011570:Psychiatry; D012017:Referral and Consultation; D013624:Taiwan / Q000453:epidemiology
D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D014150:Antipsychotic Agents