[Psychiatric consultation before liver transplantation]

Since the long-term results of transplantations are highly dependent on patient compliance, prior to the decision to undertake such an operation, the psychiatrist is often asked whether there are any conditions presenting that would militate against the necessary cooperation.

Between 1992 and 1993, 35 patients were sent for psychiatric counselling prior to liver transplantation, and were evaluated using a standardised questionnaire. 23 of the 35 patients were submitted to psychological testing.

in 23 cases, a psychiatric diagnosis was established in accordance with the ICD-10 criteria. The largest group was formed by the addictive diseases in this study, in particular alcohol dependence. Eight patients proved to have organ-related mental disturbances, other diagnoses such as depressive disorders or personality disorders were less common. In four cases, the psychiatrist was unable to recommend the liver transplantation. In such cases as these, the tasks of the psychiatrist is not restricted simply to a diagnostic assessment, but must also include a therapeutic approach intended to enable the patient to cope with the coming stresses and requirements.