Indicators of Complex Care During the Consultation-Liaison Psychiatry Activity at the Transplant Center of the Policlinico Hospital, Modena

Mattei, Giorgio; Laghi, Alessandro; Balduzzi, Sara; Moscara, Maria; Piemonte, Chiara; Reggianini, Corinna; Rigatelli, Marco; Ferrari, Silvia; Pingani, Luca; Galeazzi, Gian Maria

doi:10.1016/j.transproceed.2017.09.031

Cited by 6 publications

(6 citation statements)

References 20 publications

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“…This change, though, was more marked in the older research participants. One possible way to interpret this finding is the increased amount of patients referred for pre-OLTx, who are mostly male [ 36 ]. Gender-related issues in geriatric patients are very relevant, considering the higher proportion of more severe forms of some disorders in male patients, e.g., depression [ 37 ]: awareness on the consequent increased risk of self-harm behaviours should be an important priority in the organization of the CLPS as well as in the definition of training activities.…”

Section: Discussionmentioning

confidence: 99%

Is Consultation-Liaison Psychiatry ‘Getting Old’? How Psychiatry Referrals in the General Hospital Have Changed over 20 Years

Ferrari

Mattei

Marchi

et al. 2020

IJERPH

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There is an ever-growing awareness of the health-related special needs of older patients, and Consultation-Liaison Psychiatry Services (CLPS) are significantly involved in providing such age-friendly hospital care. CLPS perform psychiatric assessment for hospitalized patients with suspected medical-psychiatric comorbidity and support ward teams in a bio-psycho-social oriented care management. Changes in features of the population referred to a CLPS over a 20-year course were analysed and discussed, especially comparing older and younger referred subjects. Epidemiological and clinical data from all first psychiatric consultations carried out at the Modena (North of Italy) University Hospital CLPS in the period 2000–2019 (N = 19,278) were included; two groups of consultations were created according to the age of patients: OV65 (consultations for patients older than 64 years) and NONOV65 (all the rest of consultations). Consultations for OV65 were about 38.9% of the total assessments performed, with an average of approximately 375 per year, vs. the 589 performed for NOV65. The number of referrals for older patients significantly increased over the 20 years. The mean age and the male/female ratio of the sample changed significantly across the years in the whole sample as well as both among OV65 and NOV65. Urgent referrals were more frequent among NOV65 and the rate between urgent/non urgent referrals changed differently in the two subgroups. The analysis outlined recurring patterns that should guide future clinical, training and research activities.

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Section: Discussionmentioning

confidence: 99%

Is Consultation-Liaison Psychiatry ‘Getting Old’? How Psychiatry Referrals in the General Hospital Have Changed over 20 Years

Ferrari

Mattei

Marchi

et al. 2020

IJERPH

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“…Further investigation on contributing factors for prolonged post-operative psychiatric disorders in LDLT donors is necessary. As previous reports mentioned [20][21][22][23][24], the current report suggested that the consultation-liaison psychiatry services can play the significant role in the field of LT and a long-term careful follow-up by psychiatrists is extremely important for LDLT donors who develop psychiatric disorders.…”

Section: Discussionmentioning

confidence: 70%

Clinical Features and Long-Term Outcomes of Living Donors of Liver Transplantation Who Developed Psychiatric Disorders

et al. 2020

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Departmental sources Background: In the field of living donor liver transplantation (LDLT), it is important to ensure donor's psychological well-being. We report on clinical features and long-term outcomes of LDLT donors who developed psychiatric disorders after their donor operations. Additionally, we compare patient backgrounds, as well as surgical and perioperative aspects between LDLT donors with and without postoperative psychiatric complications. Material/Methods: Between November 1998 and March 2018, we identified 254 LDLT donors at our hospital. Among these, we investigated those who had newly developed psychiatric complications and required psychiatric treatment after donor operation. Results: The median duration of follow-up was 4 years. Sixty-five donors were lost to follow-up. Eight donors (3.1%) developed postoperative psychiatric complications, including major depressive disorder in 4, panic disorder in 2, conversion disorder and panic disorder in 1, and adjustment disorder in 1. The median duration from donor surgery to psychiatric diagnosis was 104.5 days (range, 12 to 657 days) and the median treatment duration was 18 months (range, 3 to 168 months). Of those, 3 donors required psychiatric treatment over 10 years, and 4 donors remained under treatment. The duration of hospital stay after donor operation was significantly longer and perioperative complications with Clavien classification greater than grade IIIa were more frequent in donors with psychiatric complications than in those without psychiatric complications (P=0.02 and P=0.006, respectively). Conclusions: Accurate diagnosis and appropriate treatment for psychiatric disorders by psychiatrists and psychologists are important during LDLT donor follow-up. Minimization of physiological complications might be important to prevent postoperative psychiatric complications in LDLT donors.

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“…Thirty-one patients were taking psychotropic medications at the index referral. Further details of the sample are described elsewhere [6].…”

Section: Resultsmentioning

confidence: 99%

“…To be included in this study, patients should fulfill the following inclusion criteria: 1. being referred for inclusion in the waiting list for liver transplantation; 2. having an age between 18 and 70 years old; 3. being repeatedly referred (at least twice). This group of patients also constituted the cases in a previous case-control study, focusing more specifically on predictors of complexity [6]. The study was approved by the Ethical Committee of the Province of Modena and conducted according to the principles of the Declaration of Helsinki.…”

Section: Methodsmentioning

confidence: 99%

“…Psychosocial risk factors are known to be particularly frequent and/or complex among candidates to liver transplantation, both before and after surgery [5]. Some of these patients suffer from HCV-related liver failure and often present with comorbid psychiatric disorders, frequently depression [6]. Heo et al [5] argued that the prevalence of anxiety disorders is higher before transplantation, rather than after; furthermore, such disorders are frequently associated with hepatitis and cirrhosis.…”

Section: Introductionmentioning

confidence: 99%

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Stability of Psychiatric Diagnoses in Candidates to Liver Transplantation Referred to a Consultation-Liaison Psychiatry Service

Mattei

Moscara

Balducci

et al. 2019

JCM

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Objective: To investigate the stability over time of the psychiatric diagnoses among candidates to liver transplantation referred to a consultation-liaison psychiatric service. Method: Descriptive study, carried out at the Consultation-Liaison Psychiatry Service (CLPS) placed at the Modena (Italy) General University Hospital. All patients waiting for liver transplantation and repeatedly referred to the CLPS were enrolled. The observation period was from 1 January 2008 to 31 December 2013. Pearson’s coefficients were calculated to measure diagnostic stability (index referral vs. last referral). Results: One hundred patients were assessed (males 67%; mean age 53 ± 7 years old). The mean number of referrals for patients was 3 ± 2. The stability rate of psychiatric diagnosis was 64%. The following diagnoses or conditions were all significantly stable (i.e., all featured by r > 0.5 and p < 0.05): Adjustment disorder, depressive disorder, comorbid anxiety/depressive disorder, substance use disorder (including alcohol), absence of any disorder, and presence of any disorder. Conclusions: The good level of diagnostic stability displayed in the sample may be a function of the clinical and organizational “style” of the CLPS, namely the focus on identifying the prevailing personality traits, defensive mechanisms, and relational patterns.

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Indicators of Complex Care During the Consultation-Liaison Psychiatry Activity at the Transplant Center of the Policlinico Hospital, Modena

Cited by 6 publications

References 20 publications

Is Consultation-Liaison Psychiatry ‘Getting Old’? How Psychiatry Referrals in the General Hospital Have Changed over 20 Years

Is Consultation-Liaison Psychiatry ‘Getting Old’? How Psychiatry Referrals in the General Hospital Have Changed over 20 Years

Clinical Features and Long-Term Outcomes of Living Donors of Liver Transplantation Who Developed Psychiatric Disorders

Stability of Psychiatric Diagnoses in Candidates to Liver Transplantation Referred to a Consultation-Liaison Psychiatry Service

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