Scant research exists on the psychiatric history of patients with acute liver failure (ALF) presenting for liver transplantation. This study compared psychiatric profiles of patients in ALF due to acetaminophen (APAP) overdose versus other etiologies. Methods: Retrospective clinical chart review of patients referred for liver transplantation at a single center from January 2004 through December 2012. Results: 105 patients presented in ALF, mean age 42.4 years (SD 15.3, range 17 to 71), predominantly female (n 76, 72.4%), and mostly Caucasian (n 72, 68.6%) or African American (n 22, 21.0%). Caucasian patients were significantly more likely to have substance abuse histories compared to African American patients (51.4% vs. 25.0%; p=.03). Similarly, family psychiatric histories were more common in Caucasian than in African American patients (39.7% vs. 12.5%; p=.04). There were no other significant differences in psychiatric characteristics between races. Psychiatric characteristics of patients who presented with overdose versus other etiologies outlined in Table 1.

Conclusions: There is a significant presence of psychiatric diagnoses, substance abuse histories, and psychiatric treatment histories in patients presenting in ALF due to overdose compared to other etiologies. There was no significant difference in support-related concerns for transplant, indicating that a supportive network may not necessarily be protective. This emphasizes the importance of thorough assessments and close monitoring when prescribing APAP-containing medications, especially in patients with known psychiatric histories.

CITATION INFORMATION: Rebhan N, Bebanic M, Yoshida A, Macaulay T, Goldstein E, Ho C.-X, Eshelman A, Abouljoud M, Jesse M, Rizzari M. Psychiatric Characteristics of Acute Liver Failure Patients: Acetaminophen Overdose versus Other Etiologies. Am J Transplant. 2016;16 (suppl 3).

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