Covert HE, driving concern, and pre-listing depression — CASC communication station

Station brief

Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar embedded with hepatology / transplant assessment clinic. [1]

Candidate instructions. Explain that subtle cognitive change in cirrhosis may be covert hepatic encephalopathy, not a character flaw. Explore sleep–wake change, attention, mood, alcohol recovery, and medication adherence (especially lactulose). Address driving as a shared safety concern using clinical language and local process — do not invent statute numbers. Link depression and adherence to transplant evaluation constructively. Check suicide risk. Agree a collaborative plan with hepatology. [1][2][3]