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Psychiatric Consultations in Pre-orthotopic Liver Transplantation Patients with Substance Use Disorders: Focus On Timing of Cessation and Referral and Retention by Community Services

Published online by Cambridge University Press:  15 April 2020

C. Reggianini
Affiliation:
Department of Clinical Diagnostic and Public Health Medicine Section of Psychiatry, University of Modena, Reggio Emilia, Modena, Italy
M. Moscara
Affiliation:
Mental Health Department, AUSL Modena, Modena, Italy
S. Ferrari
Affiliation:
Department of Clinical Diagnostic and Public Health Medicine Section of Psychiatry, University of Modena, Reggio Emilia, Modena, Italy
A. Laghi
Affiliation:
Department of Clinical Diagnostic and Public Health Medicine Section of Psychiatry, University of Modena, Reggio Emilia, Modena, Italy
G. Mattei
Affiliation:
Department of Clinical Diagnostic and Public Health Medicine Section of Psychiatry, University of Modena, Reggio Emilia, Modena, Italy
C. Piemonte
Affiliation:
Department of Clinical Diagnostic and Public Health Medicine Section of Psychiatry, University of Modena, Reggio Emilia, Modena, Italy
M. Rigatelli
Affiliation:
Department of Clinical Diagnostic and Public Health Medicine Section of Psychiatry, University of Modena, Reggio Emilia, Modena, Italy
G. Galeazzi
Affiliation:
Department of Clinical Diagnostic and Public Health Medicine Section of Psychiatry, University of Modena, Reggio Emilia, Modena, Italy

Abstract

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Introduction

In Italy, 6 months of abstinence from alcohol/substances are required before OLT, evidence for this recommendation remaining controversial. No standard approach linking abstinence duration at the index psychiatric pre-OLT evaluation to referral to Community Services is followed.

Aims

To report data of the Modena Consultation-Liaison Psychiatric Service (MCLPS) for pre-OLT patients with Substance Use Disorders (SUDs), and to evaluate patients' concordance with referrals.

Methods

Case-control study. Data source: database of MCLPS. Psychiatric evaluations pre-OLT from 01/01/2008 to 31/12/2013 were extracted. Patients were controls if they had a SUD and abstinent for more than 6 months; cases if they had a SUD with less than 6 months of abstinence. Chi-squared analysis was performed with STATA 13.0.

Results

515 consultations were requested for 309 pre-OLT patients, 36.3% (N=112) of patients had a current or past SUD. Controls were 80 (71.3%), while cases – who had stopped use less than 6 months before the consultation, or were still using- were 20 (17.9%). 52.5% of controls (N=42) and 85.0% of cases (N=17) were referred to community services (Chi 5.71; p=0.02). 70.0% of cases (N=14) and 33.6% of controls (N=27) were seen at least twice (Chi 7.22; p=0.01). 16.7% (N=2) of cases and 23.5 % (N=4) of controls referred to community services reported concordance with Consultant's recommendation at re-assessment, a non-significant difference with cases (Chi 0.00; p=1.00).

Conclusions

Consistently with previously research in this field, no difference of concordance with recommendations emerged between patients with SUD with different duration of abstinence.

Type
Article: 0490
Copyright
Copyright © European Psychiatric Association 2015
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