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Mini-Oral Communications 1
12.252 - Psychiatric disorders in patients undergoing intestinal transplantation.
Presenter: Charlotte , Pither, , United Kingdom Authors: Charlotte Pither1, Green Jackie1, Andrew Butler2, Bridget Chukualim1, Susanna West1, Simon Gabe3, Stephen Middleton1
Psychiatric disorders in patients undergoing intestinal transplantation.
Charlotte Pither1, Green Jackie1, Andrew Butler2, Bridget Chukualim1, Susanna West1, Simon Gabe3, Stephen Middleton1
1Gastroenterology, Cambridge university hospitals NHS Foundation trust, Cambridge, United Kingdom; 2Transplantation Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; 3Intestinal failure unit, St Marks Hospital and academic institute, London, United Kingdom
This is a service analysis of 25 patients undergoing transplantation examining the frequency and types of psychiatric disorder (PD).
The notes of 25 patients transplanted since 2007 were available for analysis. 5/25 had deceased at the time of data collection.
Pre-transplant: 14/25 had a history of a single psychiatric disorder (SPD); (depression.) 3/25 had 2 psychiatric diagnoses (DPD) (depression with anxiety). 3/25 suffered from chronic pain syndrome and one patient had this as an isolated diagnosis without any other PD.
Post transplant: 10/14 patients still had a SPD however some had acquired a second diagnosis with 3/14 having DPD (anxiety with depression in most cases) with suicidal ideation in 2. Those with DPD pre-operatively did not improve. Depression resolved in 1/14 after transplant. One patient without prior history developed DPD in the post-operative course. Only 3/25 surviving patients are free of any psychological diagnosis post- transplant. The presence of other problems in the cohort such as chronic pain syndrome in 4/25, medical non-compliance in 3/25, cyclizine dependency in 2/25 and recreational drug use suspected in 1 were also identified. Problems with body image relating to the stoma were experienced by 2/25 patients.
Patients with DPD post-transplant were more likely to be living alone compared to those with one or no PD.
The incidence of psychiatric disorder in patients embarking on transplant is high and relates to their history of chronic illness. The additional stress of the transplant operation and the long in-hospital rehabilitation period takes its toll on patients’ emotional health and many acquire further psychiatric diagnoses. Managing the psychiatric health of patients is important for successful rehabilitation and their long-term health and wellbeing.
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