A simulation-based course for pain management: Improving skills in the utilisation of bio-psychosocial formulation in non-psychiatrists

Abstract

tional registry on reconstructive transplantation. Results: 50 hand transplants have been performed and over 10 face transplants. Complications have included rejection, poor functional outcomes, hip replacement, cancer and two deaths in face transplant patients. The majority of patients have had varying degrees of functional improvement and sensory return with quality of life and life satisfaction improvements did not necessarily correlated with functional outcome. Noncompliance, depression including a suicide attempt in one case and malingering (feigned blindness) are some of the psychiatric sequelae reported. Social workers, psychologists and psychiatrists have all participated in the evaluation of candidates but no standard psychosocial assessment has been mandated. Body image and the capacity to comply with lengthy rehabilitation are unique features of the assessment. Conclusion: Reconstructive transplantation is increasing and hand transplantation is no longer considered solely a research activity. Psychosomatic medicine specialists assist in the selection of optimal candidates. Standardization and education of the unique aspects of reconstructive transplantation are needed and training of C/L psychiatrists interested in supporting this population of patients is needed.