Citation

Chernyak Y, Teh L, Henderson DR, Patel A. Prog. Transplant. 2019; ePub(ePub): ePub.

Affiliation

Department of Psychiatry, Indiana University School of Medicine, IU Health Neurosciences Center, Indianapolis, IN, USA.

Copyright

(Copyright © 2019, North American Transplant Coordinators Organization, Publisher SAGE Publishing)

DOI

10.1177/1526924819893300

PMID

31876252

Abstract

There is a high prevalence of depression among left ventricular assist device patients, who present with an increased risk of suicidality given access to means via the device either with nonadherence or disconnection. Suicidality via device nonadherence/disconnection is an underresearched clinical issue, as paradoxically this life-saving procedure can also provide a method of lethal means to patients with significant mental health concerns. A case study is used to highlight the course of an attempted suicide by ventricular assistive device nonadherence. Clinical implications and recommendations for practice include a thorough psychological evaluation presurgery, monitoring quality of life and coping styles before and after placement, psychological testing, outlining specific suicide protocols, psychiatric care considerations for patients with highly specialized medical devices, and related ethical concerns.

Language: en

Keywords

LVAD; depression; left ventricular assist device; nonadherence; noncompliance; suicide