title: A Ventricular Assist Device Recipient and Suicidality: Multidisciplinary Collaboration With a Psychiatrically Distressed Patient.
abstract: BACKGROUND
  Ventricular assist device (VAD) recipients are at high risk of depression and anxiety, and poor psychosocial functioning is associated with worse medical outcomes.
  
  
  OBJECTIVE
  We present a case of a 31-year-old depressed patient who demonstrated passive suicidal behavior through multiple episodes of noncompliance, including temporarily discontinuing warfarin (Coumadin) several months after VAD implantation. The patient's psychosocial and medical histories and outcomes are presented.
  
  
  CONCLUSIONS
  This case underscores the importance of pre-VAD as well and ongoing psychosocial evaluation and management for this unique patient population.
  
  
  CONCLUSIONS
  Medical teams who are treating patients with cardiovascular disease who are under consideration for VAD or heart transplantation need to be aware of the multitude of ways in which patients can express depressed and suicidal mood and work with a multidisciplinary team to treat such symptoms to optimize patients' success with VAD/heart transplantation.
authors.affiliation: Wendy E. Balliet, PhD Assistant Professor, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston. Alok Madan, PhD, MPH Assistant Professor, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston. Michael L. Craig, MD Assistant Professor, Department of Medicine and Cardiothoracic Transplant Center, Medical University of South Carolina, Charleston. Eva R. Serber, PhD Associate Professor, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston. Jeffery J. Borckardt, PhD Professor, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston. Christine Pelic, MD Assistant Professor, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston. Kelly Barth, DO Associate Professor, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston. Anthony Hale, RN Nurse Coordinator, Cardiothoracic Transplant Center, Medical University of South Carolina, Charleston. Adrian B. van Bakel, MD, PhD Professor, Department of Medicine and Cardiothoracic Transplant Center, Medical University of South Carolina, Charleston. Jennifer L. Peura, MD Associate Professor, Department of Medicine and Cardiothoracic Transplant Center, Medical University of South Carolina, Charleston.
authors.forename: Wendy E
authors.initials: WE
authors.lastname: Balliet
authors.forename: Alok
authors.initials: A
authors.lastname: Madan
authors.forename: Michael L
authors.initials: ML
authors.lastname: Craig
authors.forename: Eva R
authors.initials: ER
authors.lastname: Serber
authors.forename: Jeffery J
authors.initials: JJ
authors.lastname: Borckardt
authors.forename: Christine
authors.initials: C
authors.lastname: Pelic
authors.forename: Kelly
authors.initials: K
authors.lastname: Barth
authors.forename: Anthony
authors.initials: A
authors.lastname: Hale
authors.forename: Adrian B
authors.initials: AB
authors.lastname: van Bakel
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Peura
mesh_terms: D000328:Adult; D003866:Depressive Disorder / Q000523:psychology*; D006333:Heart Failure / Q000523:psychology* / Q000628:therapy*; D006353:Heart-Assist Devices; D006801:Humans; D008297:Male; D013405:Suicide / Q000523:psychology*