Journal Article Annotations
2020, 1st Quarter
Paula Zimbrean, MD
March 31, 2020
Also of interest:
85% of hospitals with a transplant centre offered mental health services and 37% offered chemical dependency services.
Strength and weaknesses:
The paper reports the results of a cross sectional assessment of hospital related mental health services, as resulted from the American Hospital Association (AHA) 2017-2018 Annual Survey Hospital and form the 2017-2018 Area Health Resource File county level database. The authors analysed the availability of mental health services and chemical dependency services in hospital based on the types of transplants offered, ownership, number of hospital beds, government payment percentages and other public health parameters.
When new transplant programs begin evaluating candidates or when established programs expand, administrators and transplant physicians often assume that existing mental health services at that hospital will meet the needs for psychiatric assessment and care for liver transplant candidates, recipients and organ donors. This study shoes that in many cases these hospitals do not have mental health service established. This study did not evaluate if the existing mental health services meet the needs of the transplantation centres, as many psychiatric clinics find it difficult to provide services to patients with severe medical conditions. The results of this study are helpful for all psychiatrists who collaborate with the transplant centres as it supports the need for integrated mental health care for transplant candidates and recipients
Type of study:
This is a case report describing a 62y/o man with a history of depression, on 50 mg of sertraline, who developed serotonin syndrome following administration of methylene blue for perioperative vasoplegia during left ventricular disease implantation. Depression has a high prevalence among patients with heart disease however it can also be difficult to diagnose when patients have neurovegetative symptoms due to their medical illness. Cl psychiatrists often must differentiate between normal illness behaviour and clinical depression. Treatment for depression typically improves quality of life and may improve medical outcomes after LVADs or transplantation, however it is important to consider the risks of antidepressant treatment in the perioperative setting, as illustrated by this case report. When psychotherapy is not indicated or feasible, delaying the start of an antidepressant or holding the antidepressant in the perioperative setting can be considered.
Type of study: