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Bajić Ž, Vuk-Pisk S, Filipčić I, Šimunović Filipčić I. Sex and gender differences in cancer in individuals with severe mental disorders. Curr Opin Psychiatry 2024; 37:350-355. [PMID: 39011722 DOI: 10.1097/yco.0000000000000958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/17/2024]
Abstract
PURPOSE OF REVIEW Although cancer incidence is similar between individuals with severe mental disorders (SMD) and the general population (GP), survival rates are lower, particularly in those with schizophrenia. While the scientific and medical communities acknowledge sex differences in cancer mechanisms, including risk factors and cancer types, less is known about sex and gender disparities in incidence, mortality, and care pathways among those with SMD. This review aims to explore these differences in cancer among individuals with SMD. RECENT FINDINGS Current evidence on sex and gender differences in cancer care for SMD is limited. It is unclear how these factors affect cancer incidence and mortality in the SMD population, and if they correspond to those in the GP. The literature frequently omits detailed information on sex-based differences in SMD-related cancer rates, complicating conclusive analysis. Moreover, people with SMD experience significant challenges in accessing cancer screenings compared to the GP, and findings on sex and gender disparities in this context remain inconclusive. SUMMARY This review emphasizes that while significant sex and gender-based differences in cancer mechanisms, incidence, and survival exist within the GP, they have not been fully integrated into clinical practice. It underscores the need of addressing these differences in cancer incidence, outcomes, mortality, and care pathways to enhance treatment for individuals with SMD.
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Affiliation(s)
- Žarko Bajić
- University Psychiatric Clinic Sveti Ivan, Zagreb
| | - Sandra Vuk-Pisk
- University Psychiatric Clinic Sveti Ivan, Zagreb
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek
| | - Igor Filipčić
- University Psychiatric Clinic Sveti Ivan, Zagreb
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek
- School of Medicine, University of Zagreb
| | - Ivona Šimunović Filipčić
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek
- Department of Psychiatry and Psychological Medicine, University Hospital Center Zagreb, Zagreb, Croatia
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Qu Y, Nie D, Song Y, Cai X, Gong Y, Chen S, Ye J, Li J. Bibliometric analysis of research on digestive system tumors and depression. Front Psychol 2024; 15:1414528. [PMID: 39156806 PMCID: PMC11327056 DOI: 10.3389/fpsyg.2024.1414528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 07/15/2024] [Indexed: 08/20/2024] Open
Abstract
Background Malignant tumors of the digestive system pose a serious threat to human health due to their highly malignant nature. Depression, as the most common psychiatric symptom of digestive system tumors, has attracted much attention regarding its potential relationship with these tumors. A thorough investigation into the connection between digestive system tumors and depression is extremely important for strengthening patients' quality of life and treatment outcomes. Methods From 2014 to 2023, we conducted a literature search using specific keywords in the Web of Science Core Collection (WoSCC) and performed visual analysis of the selected literature using Microsoft Excel, CiteSpace, and VOSviewer software. In this study, we analyzed countries, institutions, authors, journals, and keywords. Results A total of 384 research articles on the relationship between digestive system tumors and depression were identified. The number of publications showed a gradual increase over time. In terms of disciplinary distribution, Oncology, Health Care Sciences Services, and Medicine General Internal ranked top in terms of publication volume. In terms of geographical distribution, China and the United States were the countries contributing the most publications. Additionally, Maastricht University contributed the most publications. Regarding authors, Beekman, Aartjan T.F. and Dekker, Joost had the highest number of publications, while Zigmond, A.S. had the most citations. It is worth mentioning that Supportive Care in Cancer was the journal with the most publications in this field. In terms of keyword analysis, research mainly focused on mechanisms and treatment strategies related to the relationship between digestive system tumors and depression. Conclusion The relationship between digestive system tumors and depression has become a new research hotspot in recent years, offering new directions for future research. This research reveals novel perspectives on comprehending the connection between the two, which can guide future research and practice.
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Affiliation(s)
- Ying Qu
- Department of Oncology, The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Duorui Nie
- Graduate School, Hunan University of Chinese Medicine, Changsha, China
| | - Yuwei Song
- School of Traditional Chinese Medicine, Hunan University of Chinese Medicine, Changsha, China
| | - Xiaojun Cai
- Department of Oncology, The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Yilin Gong
- Department of Oncology, The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Sheng Chen
- Department of Oncology, The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Jia Ye
- Department of Gynecology, The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, China
| | - Jing Li
- Department of Oncology, The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, China
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Sanghvi DE, Chen MS, Bonanno GA. Prospective trajectories of depression predict mortality in cancer patients. J Behav Med 2024; 47:682-691. [PMID: 38615300 DOI: 10.1007/s10865-024-00485-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 03/14/2024] [Indexed: 04/15/2024]
Abstract
An ever-growing body of empirical evidence has demonstrated the relationship between depression and cancer. The objective of this study was to examine whether depression trajectories predict mortality risk above and beyond demographics and other general health-related factors. Participants (n = 2,345) were a part of the Health and Retirement Study. The sample consisted of patients who were assessed once before their cancer diagnosis and thrice after. Depressive symptoms and general health-related factors were based on self-reports. Mortality risk was determined based on whether the patient was alive or not at respective time points. Latent Growth Mixture Modeling was performed to map trajectories of depression, assess differences in trajectories based on demographics and general health-related factors, and predict mortality risk. Four trajectories of depression symptoms emerged: resilient (69.7%), emerging (13.5%), recovery (9.5%), and chronic (7.2%). Overall, females, fewer years of education, higher functional impairment at baseline, and high mortality risk characterized the emerging, recovery, and chronic trajectories. In comparison to the resilient trajectory, mortality risk was highest for the emerging trajectory and accounted for more than half of the deaths recorded for the participants in emerging trajectory. Mortality risk was also significantly elevated, although to a lesser degree, for the recovery and chronic trajectories. The data highlights clinically relevant information about the depression-cancer association that can have useful implications towards cancer treatment, recovery, and public health.
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Affiliation(s)
- Drishti Enna Sanghvi
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY, USA.
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA.
- New York Presbyterian Hospital-Westchester Behavioral Health Center, White Plains, NY, USA.
| | - Mark Shuquan Chen
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY, USA
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA
| | - George A Bonanno
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, NY, USA
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Shang HX, Ning WT, Sun JF, Guo N, Guo X, Zhang JN, Yu HX, Wu SH. Investigation of the quality of life, mental status in patients with gynecological cancer and its influencing factors. World J Psychiatry 2024; 14:1053-1061. [PMID: 39050200 PMCID: PMC11262931 DOI: 10.5498/wjp.v14.i7.1053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/07/2024] [Accepted: 06/14/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Having a gynecological tumor or undergoing treatment can be a traumatic experience for women, as it affects their self-image and sexual relationships and can lead to psychological reactions. Psychological adjustment following cancer occurrence remains a key issue among the survivors. AIM To examine the current status of quality of life (QoL), anxiety, and depression in patients with gynecological cancer and to analyze the factors associated with it. METHODS Data for 160 patients with gynecological malignancies treated at Shanxi Bethune Hospital from June 2020 to June 2023 were collected and analyzed retrospectively. Patients' QoL was assessed using the European Organization for Research on Treatment of Cancer Quality of Life Questionnaire Core 30 and the Functional Assessment of Cancer Therapy-General Questionnaire. Their emotional status was evaluated using the Self-Rating Anxiety/Depression Scale. The associated factors of anxiety and depression were analyzed. RESULTS The overall QoL score of the patients 6 months after surgery was 76.39 ± 3.63 points. This included low levels of social and emotional function and severe fatigue and pain. The scores for physiological, functional, emotional, social, and family well-being exhibited an upward trend following surgery compared with those before surgery. One month after surgery, some patients experienced anxiety and depression, with an incidence of 18.75% and 18.13%, respectively. Logistic analysis revealed that good sleep was a protective factor against anxiety and depression in patients with gynecological tumors, whereas physical pain was a risk factor. CONCLUSION Patients with gynecological malignancies often experience anxiety and depression. By analyzing the factors that affect patients' QoL, effective nursing measures can be administered.
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Affiliation(s)
- Hai-Xia Shang
- Department of Gynaecology and Obstetrics, The Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, Shanxi Province, China
| | - Wen-Ting Ning
- Department of Gynaecology and Obstetrics, The Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, Shanxi Province, China
| | - Jin-Fen Sun
- Department of Gynaecology and Obstetrics, The Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, Shanxi Province, China
| | - Nan Guo
- Department of Gynaecology and Obstetrics, The Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, Shanxi Province, China
| | - Xin Guo
- Department of Gynaecology and Obstetrics, The Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, Shanxi Province, China
| | - Jan-Nan Zhang
- Department of Gynaecology and Obstetrics, The Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, Shanxi Province, China
| | - Hong-Xin Yu
- Department of Gynaecology and Obstetrics, The Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, Shanxi Province, China
| | - Su-Hui Wu
- Department of Gynaecology and Obstetrics, The Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032, Shanxi Province, China
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Teles ALS, Baldaçara L, da Silva AG, Leite VDS, Benito ALP, Ribeiro FV. Interfaces between oncology and psychiatry. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2024; 70:e2024S129. [PMID: 38865548 PMCID: PMC11164258 DOI: 10.1590/1806-9282.2024s129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 10/26/2023] [Indexed: 06/14/2024]
Affiliation(s)
| | - Leonardo Baldaçara
- Universidade Federal do Tocantins – Palmas (TO), Brazil
- Brazilian Psychiatric Association – Rio de Janeiro (RJ), Brazil
| | - Antônio Geraldo da Silva
- Brazilian Psychiatric Association – Rio de Janeiro (RJ), Brazil
- Universidade Federal de Minas Gerais – Belo Horizonte (MG), Brazil
| | - Verônica da Silveira Leite
- Universidade Federal do Tocantins – Palmas (TO), Brazil
- Brazilian Psychiatric Association – Rio de Janeiro (RJ), Brazil
| | - Ana Lucia Paya Benito
- Brazilian Psychiatric Association – Rio de Janeiro (RJ), Brazil
- Brazilian Society of Psycho-oncology – São Paulo (SP), Brazil
| | - Flávio Veloso Ribeiro
- Universidade Federal do Tocantins – Palmas (TO), Brazil
- Brazilian Psychiatric Association – Rio de Janeiro (RJ), Brazil
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Tang T, Yu H, Xu S, Zhong Y, Ma J, Zhao T. Causal effects of endometriosis on cancer risk: A Mendelian randomization study. Int J Cancer 2024; 154:1948-1954. [PMID: 38323658 DOI: 10.1002/ijc.34876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/14/2023] [Accepted: 01/19/2024] [Indexed: 02/08/2024]
Abstract
Endometriosis has been reported in epidemiological studies to be associated with certain types of cancer. However, the presence of reverse causality and residual confounding due to common risk factors introduces uncertainty regarding the extent to which endometriosis itself contributes to the development of cancer. We performed the Mendelian randomization (MR) to investigate the causal associations between endometriosis and 34 different types of cancers. The results of the inverse-variance-weighted (IVW) model suggested that genetic predisposition to endometriosis was causally associated with an increased risk for ovarian cancer (OR = 3.2913; p-value = .0320). The genetic liabilities to endometriosis had causal associations with the decreased risk for skin cancer (OR = 0.9973; p-value = .0219), hematological cancer (OR = 0.9953; p-value = .0175) and ER- breast cancer (OR = 0.6960; p-value = .0381). The causal association of the above combinations were robust by test of heterogeneity and pleiotropy. Together, our study suggests that endometriosis had causal effect on cancer risk.
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Affiliation(s)
- Tianyou Tang
- The College of Pediatrics, Chongqing Medical University, Chongqing, China
| | - Huilin Yu
- The Second Medicine College, Chongqing Medical University, Chongqing, China
| | - Sipei Xu
- The First Medicine College, Chongqing Medical University, Chongqing, China
| | - Yi Zhong
- The College of Pediatrics, Chongqing Medical University, Chongqing, China
| | - Jie Ma
- Department of Pharmacology, Pharmaceutical Engineering College, Chongqing Chemical Industry Vocational College, Chongqing, China
| | - Tingting Zhao
- Laboratory of Human Function Experimental Teaching and Management Center of Chongqing Medical University, Chongqing, China
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Linz S, Jerome-D'Emilia B. Barriers and Facilitators to Breast Cancer Screening for Women With Severe Mental Illness. J Am Psychiatr Nurses Assoc 2024; 30:576-589. [PMID: 36475418 DOI: 10.1177/10783903221140600] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Women with severe mental illness (SMI) are diagnosed with breast cancer at later stages, with greater mortality rates than the general population. Although breast cancer screening is an acknowledged strategy for early breast cancer detection, women with SMI are 32% to 50% less likely to have regular mammography screenings, yet the specific factors related to the disparity in this population have not been determined. AIM The purpose of this study was to identify the barriers and facilitators toward breast cancer screening in women diagnosed with SMI. METHOD In collaboration with a community-based mental health services agency, women aged 40 and older, diagnosed with SMI, and treated at that agency, were identified and asked if they were willing to participate. Fifteen women agreed to be interviewed. An interpretive descriptive approach was utilized to analyze the qualitative data. RESULTS The themes elicited included barriers and facilitators to screening. Barriers found were: Psychiatric Symptoms, Fear, Distrust in the Health care System, and Not my Priority. Among the facilitators were Support, Good Health care Experiences, Make it Easy, Integrated Care, and Self-Care. CONCLUSION Unique to this study was the understanding by participants that physical health needed to be integrated into their mental health care services through direct support and education, primarily because the process of recovery from mental illness itself entailed the increasing ability for self-care, encompassing a focus on both mental and physical health needs and preventive care.
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Affiliation(s)
- Sheila Linz
- Sheila Linz, PhD, PMHNP-BC, RN, Rutgers, The State University of New Jersey, Camden, NJ, USA
| | - Bonnie Jerome-D'Emilia
- Bonnie Jerome-D'Emilia, PhD, MPH, RN, Associate Professor and Director of the RN-BS Program, Rutgers, The State University of New Jersey, Camden, NJ, USA
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Anderson D, Jones V. Psychological interventions for cancer-related post-traumatic stress disorder: narrative review. BJPsych Bull 2024; 48:100-109. [PMID: 37288666 PMCID: PMC10985725 DOI: 10.1192/bjb.2023.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 03/31/2023] [Accepted: 04/23/2023] [Indexed: 06/09/2023] Open
Abstract
AIMS AND METHOD This narrative review updates the evidence base for cancer-related post-traumatic stress disorder (PTSD). Databases were searched in December 2021, and included EMBASE, Medline, PsycINFO and PubMed. Adults diagnosed with cancer who had symptoms of PTSD were included. RESULTS The initial search identified 182 records, and 11 studies were included in the final review. Psychological interventions were varied, and cognitive-behavioural therapy and eye movement desensitisation and reprocessing were perceived to be most efficacious. The studies were also independently rated for methodological quality, which was found to be hugely variable. CLINICAL IMPLICATIONS There remains a lack of high-quality intervention studies for PTSD in cancer, and there is a wide range of approaches to managing these conditions, with a large heterogeneity in the cancer populations examined and methodologies used. Specific studies designed with patient and public engagement and that tailor the PTSD intervention to particular cancer populations under investigation are required.
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Affiliation(s)
| | - Victoria Jones
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
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Allar BG, Torres M, Mahmood R, Ortega G, Himmelstein J, Weissmann L, Sheth K, Rayala HJ. Unique Breast Cancer Screening Disparities in a Safety-Net Health System. Am J Prev Med 2024; 66:473-482. [PMID: 37844709 DOI: 10.1016/j.amepre.2023.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 10/07/2023] [Accepted: 10/09/2023] [Indexed: 10/18/2023]
Abstract
INTRODUCTION Breast cancer screening (BCS) disparities leave historically underserved groups more vulnerable to adverse outcomes. This study explores granular associations between BCS and patient sociodemographic factors in a large urban safety-net health system. METHODS A retrospective review among female patients ages 50-74 within an urban safety-net health system was conducted in 2019. All patients had a primary care visit in the past 2 years. Multiple patient health and sociodemographic characteristics were reviewed, as well as provider gender and specialty. Bivariate analyses and multivariable logistic regression were performed in 2022. RESULTS The BCS rate among 11,962 women was 69.7%. Over half of patients were non-White (63.6%) and had public insurance (72.3%). Patients with limited English proficiency made up 44.3% of the cohort. Compared to their sociodemographic counterparts, patients with White race, English proficiency, and Medicare insurance had the lowest rates of BCS. Serious mental illness and substance use disorder were associated with lower odds of BCS. In multivariable analysis, when using White race and English speakers as a reference, most other races (Black, Hispanic, and Other) and languages (Spanish, Portuguese, and Other) had significantly higher odds of screening ranging from 8% to 63% higher, except Asian race and Haitian Creole language. Female (versus male) and internal medicine-trained providers were associated with higher screening odds. CONCLUSIONS Multiple unique variables contribute to BCS disparities, influenced by patient and health system factors. Defining and understanding the interplay of these variables can guide policymaking and identify avenues to improve BCS for vulnerable or traditionally under-resourced populations.
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Affiliation(s)
- Benjamin G Allar
- Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Micaela Torres
- David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Rumel Mahmood
- Cambridge Health Alliance, Harvard Medical School, Cambridge, Massachusetts
| | - Gezzer Ortega
- Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jessica Himmelstein
- Department of Internal Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, Massachusetts
| | - Lisa Weissmann
- Department of Hematology/Oncology, Cambridge Health Alliance, Harvard Medical School, Cambridge, Massachusetts
| | - Ketan Sheth
- Department of Surgery, Cambridge Health Alliance, Harvard Medical School, Cambridge, Massachusetts
| | - Heidi J Rayala
- Department of Surgery, Cambridge Health Alliance, Harvard Medical School, Cambridge, Massachusetts; Division of Urology, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
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Garcia-Alcaraz C, Binda A, Gordon JR, Alpert EN, Greenwood KL, Aguilar RAC, Lucido NC, Koes D, Atterton C, Plopper MG, Wells KJ. Intervention recommendations to improve uptake of breast, cervical, and colorectal cancer screening among individuals living with serious mental illness. Cancer Causes Control 2024; 35:451-463. [PMID: 37843700 PMCID: PMC10872785 DOI: 10.1007/s10552-023-01791-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 09/04/2023] [Indexed: 10/17/2023]
Abstract
PURPOSE Few efforts have been made to inform intervention design for increasing the uptake of cancer screening in individuals living with serious mental illness (ILSMI), who have lower cancer screening rates than the general population. This qualitative study explored ILSMI's and their care team member's (CTM) recommendations on the design of a breast, colorectal, and cervical cancer screening intervention for ILSMI. METHODS Twenty-five ILSMI (mean age: 71.4 years; 60% female) and 15 CTM (mean age: 45.3 years; 80% female) were recruited through purposive sampling. Semi-structured in-depth interviews were used to collect participants' intervention suggestions. Interviews were recorded, transcribed verbatim, and imported into NVivo. Content analysis and the constant comparison method were used to analyze interview data. RESULTS ILSMI and CTMs provided several salient recommendations. ILSMI should receive disease-specific, logistical, and screening education, and primary care staff should receive education on psychopathology. Mental health providers and patient navigators should be considered as the primary interventionist. The intervention should be delivered where ILSMI receive medical or mental health services, receive community and government services, and/or via various digital media. The intervention should improve the collaboration, communication, and coordination between primary and mental health care. Findings also pointed to the implementation of trauma-informed cancer care and integrated care models comprising mental health care and primary cancer care. CONCLUSION These findings bring the skills, knowledge, and expertise of ILSM and their care team to intervention design for increasing colorectal, breast, and cervical cancer screening in ILSMI attending an intensive outpatient program.
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Affiliation(s)
- Cristian Garcia-Alcaraz
- San Diego State University/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
- San Diego State University, San Diego, CA, USA
- San Diego State University Research Foundation, San Diego, CA, USA
| | - Aleigha Binda
- San Diego State University, San Diego, CA, USA
- San Diego State University Research Foundation, San Diego, CA, USA
| | | | | | | | - Rosa A Cobian Aguilar
- San Diego State University/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
- San Diego State University, San Diego, CA, USA
- San Diego State University Research Foundation, San Diego, CA, USA
| | - Nicholas C Lucido
- San Diego State University, San Diego, CA, USA
- San Diego State University Research Foundation, San Diego, CA, USA
| | - Dina Koes
- San Diego State University Research Foundation, San Diego, CA, USA
| | | | | | - Kristen J Wells
- San Diego State University/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA.
- San Diego State University, San Diego, CA, USA.
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Shalev D, Brenner K, Carlson RL, Chammas D, Levitt S, Noufi PE, Robbins-Welty G, Webb JA. Palliative Care Psychiatry: Building Synergy Across the Spectrum. Curr Psychiatry Rep 2024; 26:60-72. [PMID: 38329570 DOI: 10.1007/s11920-024-01485-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/21/2023] [Indexed: 02/09/2024]
Abstract
PURPOSE OF REVIEW Palliative care (PC) psychiatry is a growing subspecialty focusing on improving the mental health of those with serious medical conditions and their caregivers. This review elucidates the current practice and ongoing evolution of PC psychiatry. RECENT FINDINGS PC psychiatry leverages training and clinical practices from both PC and psychiatry, addressing a wide range of needs, including enhanced psychiatric care for patients with serious medical illness, PC access for patients with medical needs in psychiatric settings, and PC-informed psychiatric approaches for individuals with treatment-refractory serious mental illness. PC psychiatry is practiced by a diverse workforce comprising hospice and palliative medicine-trained psychiatrists, psycho-oncologists, geriatric psychiatrists, other mental health professionals, and non-psychiatrist PC clinicians. As a result, PC psychiatry faces challenges in defining its operational scope. The manuscript outlines the growth, current state, and prospects of PC psychiatry. It examines its roles across various healthcare settings, including medical, integrated care, and psychiatric environments, highlighting the unique challenges and opportunities in each. PC psychiatry is a vibrant and growing subspecialty of psychiatry that must be operationalized to continue its developmental trajectory. There is a need for a distinct professional identity for PC psychiatry, strategies to navigate administrative and regulatory hurdles, and greater support for novel clinical, educational, and research initiatives.
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Affiliation(s)
- Daniel Shalev
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, 525 East 68thStreet, Box 39, New York, NY, 10065, USA.
| | - Keri Brenner
- Department of Medicine, Stanford University, Palo Alto, CA, USA
| | - Rose L Carlson
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, 525 East 68thStreet, Box 39, New York, NY, 10065, USA
| | - Danielle Chammas
- Department of Medicine, University of California: San Francisco, San Francisco, CA, USA
| | - Sarah Levitt
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Paul E Noufi
- Department of Medicine, Georgetown University, Baltimore, MD, USA
| | | | - Jason A Webb
- Department of Medicine, Oregon Health and Sciences University, Portland, OR, USA
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12
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Zhou X, Liu Q, Liu S, Wang L, Sun Z, Sun C, Cui X. Genetic prediction of the causal relationship between schizophrenia and tumors: a Mendelian randomized study. Front Oncol 2024; 14:1321445. [PMID: 38434685 PMCID: PMC10905381 DOI: 10.3389/fonc.2024.1321445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 01/26/2024] [Indexed: 03/05/2024] Open
Abstract
Background Patients with schizophrenia are at a higher risk of developing cancer. However, the causal relationship between schizophrenia and different tumor types remains unclear. Methods Using a two-sample, two-way Mendelian randomization method, we used publicly available genome-wide association analysis (GWAS) aggregate data to study the causal relationship between schizophrenia and different cancer risk factors. These tumors included lung adenocarcinoma, lung squamous cell carcinoma, small-cell lung cancer, gastric cancer, alcohol-related hepatocellular cancer, tumors involving the lungs, breast, thyroid gland, pancreas, prostate, ovaries and cervix, endometrium, colon and colorectum, and bladder. We used the inverse variance weighting (IVW) method to determine the causal relationship between schizophrenia and different tumor risk factors. In addition, we conducted a sensitivity test to evaluate the effectiveness of the causality. Results After adjusting for heterogeneity, evidence of a causal relationship between schizophrenia and lung cancer risk was observed (odds ratio [OR]=1.001, 95% confidence interval [CI], 1.000-1.001; P=0.0155). In the sensitivity analysis, the causal effect of schizophrenia on the risk of lung cancer was consistent in both direction and degree. However, no evidence of causality or reverse causality between schizophrenia and other tumors was found. Conclusion This study elucidated a causal relationship between the genetic predictors of schizophrenia and the risk of lung cancer, thereby providing a basis for the prevention, pathogenesis, and treatment of schizophrenia in patients with lung cancer.
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Affiliation(s)
- Xintong Zhou
- College of First Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Qi Liu
- College of First Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Shihan Liu
- Department of Otorhinolaryngology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Liquan Wang
- Department of Thyroid and Breast Surgery, Weifang People’s Hospital, Weifang, China
| | - Zhongli Sun
- College of First Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Changgang Sun
- College of Traditional Chinese Medicine, Weifang Medical University, Weifang, China
- Department of Oncology, Weifang Traditional Chinese Hospital, Weifang, China
| | - Xiangning Cui
- Department of Cardiovascular, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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13
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Grassi L, McFarland D, Riba M. The Risk and The Course of Cancer Among People with Severe Mental Illness. Clin Pract Epidemiol Ment Health 2023; 19:e174501792301032. [PMID: 38659632 PMCID: PMC11037550 DOI: 10.2174/17450179-v17-e211208-2021-ht2-1910-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 04/26/2024]
Abstract
The paucity of data regarding patients with Serious Mental Illness (SMI) and cancer is alarming given the fact that people with SMI, especially schizophrenia, bipolar disorders and severe depressive disorders, have in general poorer access to physical health care and higher morbidity and mortality because of physical illnesses. The aims of this review were to examine the current evidence from existing literature on the risk of developing cancer and its course among people with SMI. Equivocal results emerge regarding the risk of developing some kind of cancer among people with SMI, with contrasting data on a possible higher, similar or lower risk in comparison with the general population. In contrast, a series of studies have pointed out that patients with SMI who develop cancer are less likely to receive standard levels of cancer care, both in terms of screening, diagnosis and treatment. Also, the mortality for cancer has been confirmed to be higher than the general population. A global sensitization about these problems is mandatory in an era in which community psychiatry has been developed in all countries and that policies of prevention, treatment, follow up, and palliative care should regard all the segments of the population, including people with SMI, through an interdisciplinary approach.
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Affiliation(s)
- Luigi Grassi
- Department of Neuroscience and Rehabilitation, DInstitute of Psychiatry, University of Ferrara and University Hospital Psychiatric Unit, Ferrara, Italy
| | - Daniel McFarland
- Department of Medicine, Hofstra University, Northwell Health, Lenox Hill Hospital, New York, NY, US
| | - Michelle Riba
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- Psycho-oncology Program, University of Michigan Depression Center and Rogel Cancer Center, Ann Arbor, MI, USA
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14
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Davis LE, Sutradhar R, Bourque MA, Eskander A, Noel CW, Isenberg-Grzeda E, Vigod SN, Coburn N, Deleemans J, Bolton JM, Chan WC, Hallet J, Mahar AL. Access to symptom screening and severe symptom risk among cancer patients with major mental illness. Psychooncology 2023; 32:1557-1566. [PMID: 37592724 DOI: 10.1002/pon.6204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/28/2023] [Accepted: 08/02/2023] [Indexed: 08/19/2023]
Abstract
INTRODUCTION Cancer symptom screening has the potential to improve cancer outcomes, including reducing symptom burden among patients with major mental illness (MMI). We determined rates of symptom screening with the Edmonton Symptom Assessment System (ESAS-r) and risk of severe symptoms in cancer patients with MMI. METHODS This retrospective cohort study used linked administrative health databases of adults diagnosed with cancer between 2007 and 2020. An MMI was measured in the 5 years prior to cancer diagnosis and categorized as inpatient, outpatient, or no MMI. Outcomes were defined as time to first ESAS-r screening and time to first moderate-to-severe symptom score. Cause-specific and Fine and Gray competing events models were used for both outcomes, controlling for age, sex, rural residence, year of diagnosis and cancer site. RESULTS Of 389,870 cancer patients, 4049 (1.0%) had an inpatient MMI and 9775 (2.5%) had an outpatient MMI. Individuals with inpatient MMI were least likely to complete an ESAS-r (67.5%) compared to those with outpatient MMI (72.3%) and without MMI (74.8%). Compared to those without MMI, individuals with an inpatient or outpatient MMI had a lower incidence of symptom screening records after accounting for the competing risk of death (subdistribution Hazard Ratio 0.77 (95% CI 0.74-0.80) and 0.88 (95% CI 0.86-0.90) respectively). Individuals with inpatient and outpatient MMI status consistently had a significantly higher risk of reporting high symptom scores across all symptoms. CONCLUSIONS Understanding the disparity in ESAS-r screening and management for cancer patients with MMI is a vital step toward providing equitable cancer care.
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Affiliation(s)
- Laura E Davis
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Rinku Sutradhar
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Antoine Eskander
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Christopher W Noel
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Elie Isenberg-Grzeda
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Psychosocial Oncology, Odette Cancer Centre-Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Simone N Vigod
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, Women's College Hospital and Research Institute, Toronto, Ontario, Canada
| | - Natalie Coburn
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Julie Deleemans
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - James M Bolton
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Julie Hallet
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Alyson L Mahar
- ICES, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
- School of Nursing, Queen's University, Kingston, Ontario, Canada
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15
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Oh TK, Park HY, Song IA. Association between Preoperative Psychiatric Morbidities and Mortality after Oncologic Surgery: A Nationwide Cohort Study from 2002 to 2019 in South Korea. J Pers Med 2023; 13:1069. [PMID: 37511682 PMCID: PMC10382024 DOI: 10.3390/jpm13071069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/19/2023] [Accepted: 06/27/2023] [Indexed: 07/30/2023] Open
Abstract
We aimed to examine whether preoperative psychiatric morbidities affect 30-day postoperative mortality. Using a nationwide registration database in South Korea, the study included all patients who underwent curative cancer surgery from 1 January 2002 to 31 December 2019. Patients underwent surgery for breast, laryngeal, lung, thyroid, gastric, colorectal, esophageal, liver, pancreatic, kidney, bladder, testicular, prostate, vulvar, uterine, or brain cancer. Depression, anxiety disorder, substance abuse, and post-traumatic stress disorder were considered preoperative psychiatric morbidities. Among the 944,794 patients in the final analysis, 5490 (0.6%) died within 30 days of the surgery, and 24,370 (2.6%) had preoperative psychiatric morbidities. Multivariable logistic regression analysis showed that preoperative psychiatric morbidities were associated with a higher (adjusted odds ratio [aOR]: 1.23; 95% confidence interval [CI]: 1.09, 1.39; p = 0.001) 30-day mortality rate than the rate noted for patients without preoperative psychiatric morbidities. This association was significant in the breast (aOR: 3.31, 95% CI: 1.36, 8.07; p = 0.009), lung (aOR: 1.54, 95% CI: 1.19, 2.01; p = 0.001), and kidney (aOR: 1.87, 95% CI: 1.06, 3.31; p = 0.03) cancer groups in the subgroup analyses. In South Korea, preoperative psychiatric morbidities are considered to be associated with increased 30-day postoperative mortality.
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Affiliation(s)
- Tak-Kyu Oh
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea
- Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul 03080, Republic of Korea
| | - Hye-Yoon Park
- Department of Psychiatry, Seoul National University Hospital, Seoul 03080, Republic of Korea
- Department of Psychiatry, College of Medicine, Seoul National University, Seoul 03080, Republic of Korea
| | - In-Ae Song
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea
- Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul 03080, Republic of Korea
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16
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Pettey D, Rae J, Aubry T. An Examination of the Effectiveness of Smoking Cessation Treatment Interventions for Individuals with Severe Mental Illness: A Pilot Randomized Controlled Trial. Community Ment Health J 2023; 59:564-577. [PMID: 36327043 DOI: 10.1007/s10597-022-01041-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022]
Abstract
To evaluate the effectiveness of two different smoking cessation interventions for individuals with severe mental illness. Study participants (N = 61) randomly assigned to the SC-R group (n = 29) were offered 24 weeks of no cost Nicotine Replacement Treatment (NRT); participants assigned to the SC + group (n = 32) were offered 24 weeks of no cost NRT plus two initial individual counselling sessions of motivational interviewing and weekly psychosocial group support for 24 weeks. At 6 months the smoking cessation outcome was 7% for the SC-R group and 14% for the SC + group, but there was no statistically significant difference between the groups. Both groups showed a significant decrease in the number of cigarettes smoked per day and significant improvement in physical health functioning. Clients with severe mental illness, high prevalence of co-occurring substance use and experience of homelessness, are both interested and able to quit smoking and reduce cigarette use.
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Affiliation(s)
- Donna Pettey
- Centre for Research on Educational and Community Services, University of Ottawa, Vanier Hall, 136 Jean-Jacques Lussier Private, Ottawa, ON, K1N 6N5, Canada. .,Ottawa Branch, Canadian Mental Health Association, 311 McArthur Avenue, Ottawa, ON, K1L 8M3, Canada.
| | - Jennifer Rae
- Centre for Research on Educational and Community Services, University of Ottawa, Vanier Hall, 136 Jean-Jacques Lussier Private, Ottawa, ON, K1N 6N5, Canada.,School of Psychology, University of Ottawa, Vanier Hall, 136 Jean Jacques Lussier Private, Ottawa, ON, K1N 6N5, Canada
| | - Tim Aubry
- Centre for Research on Educational and Community Services, University of Ottawa, Vanier Hall, 136 Jean-Jacques Lussier Private, Ottawa, ON, K1N 6N5, Canada.,School of Psychology, University of Ottawa, Vanier Hall, 136 Jean Jacques Lussier Private, Ottawa, ON, K1N 6N5, Canada
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17
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Crapanzano KA, Deweese S, Pham D, Le T, Hammarlund R. The Role of Bias in Clinical Decision-Making of People with Serious Mental Illness and Medical Co-morbidities: a Scoping Review. J Behav Health Serv Res 2023; 50:236-262. [PMID: 36720760 PMCID: PMC10016362 DOI: 10.1007/s11414-022-09829-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2022] [Indexed: 02/02/2023]
Abstract
The aim of this review was to examine the evidence for the impact of explicit and implicit biases against mental illness on the clinical decision-making of primary care physicians, medical students, and nurses when they are providing care to individuals with serious mental illness for cardiovascular disease, diabetes, and cancer. Studies were identified by searching MEDLINE, EBSCO host, and PsychINFO. A total of 18 studies published between 1996 and 2020 were reviewed and summarized. The studies were divided into two groups-studies that used a simulation or vignette methodology and those with a qualitative approach (interviews and focus groups). Of the simulation/vignette studies that allowed participants to report what they would have done in various clinical scenarios, there were roughly equal numbers of neutral or negative clinical decisions that represented 80% of the relevant behavioral results. Only 21% of the findings demonstrated a clinical decision that was favorable towards people with mental illness. Of the qualitative studies, all of the studies reported behaviors (either self-reported or observed) that were likely to be biased against people with mental illness, while 3 of the studies reported mixed results. Healthcare provider bias against individuals with mental illness does exist and impacts clinical decisions negatively. Much more empirical work needs to be done to determine the full extent and impact of the problem, including how these decisions affect the lives of individuals with mental illness.
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Affiliation(s)
- Kathleen A Crapanzano
- Department of Psychiatry, LSU School of Medicine, 5246 Brittany Drive, Rm 340, Baton Rouge, Baton Rouge, LA, 70808, USA.
| | - Stephen Deweese
- Department of Psychiatry, LSU School of Medicine, 5246 Brittany Drive, Rm 340, Baton Rouge, Baton Rouge, LA, 70808, USA
| | - Diem Pham
- Department of Psychiatry, LSU School of Medicine, 5246 Brittany Drive, Rm 340, Baton Rouge, Baton Rouge, LA, 70808, USA
| | - Thanh Le
- Department of Psychiatry, LSU School of Medicine, 5246 Brittany Drive, Rm 340, Baton Rouge, Baton Rouge, LA, 70808, USA
| | - Rebecca Hammarlund
- Department of Psychiatry, LSU School of Medicine, 5246 Brittany Drive, Rm 340, Baton Rouge, Baton Rouge, LA, 70808, USA
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18
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Grassi L, Caruso R, Riba MB, Lloyd-Williams M, Kissane D, Rodin G, McFarland D, Campos-Ródenas R, Zachariae R, Santini D, Ripamonti CI. Anxiety and depression in adult cancer patients: ESMO Clinical Practice Guideline. ESMO Open 2023; 8:101155. [PMID: 37087199 PMCID: PMC10163167 DOI: 10.1016/j.esmoop.2023.101155] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/27/2023] [Accepted: 01/29/2023] [Indexed: 03/15/2023] Open
Abstract
•Anxiety and depressive disorders are common in patients with cancer. •A higher prevalence seen in patients with cancer than the general population is often underrecognised. •Psychotherapy, cognitive behavioural therapy and mindfulness-based therapies are effective treatments. •Psychopharmacological treatments have been shown to be effective treatments of anxiety and depressive disorders.
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Affiliation(s)
- L Grassi
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - R Caruso
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - M B Riba
- Department of Psychiatry, University of Michigan, Ann Arbor; University of Michigan Rogel Cancer Center, University of Michigan, Ann Arbor, USA
| | - M Lloyd-Williams
- Academic Palliative and Supportive Care Studies Group (APSCSG), Primary Care and Mental Health, University of Liverpool, Liverpool; Department of Supportive and Palliative Care, Liverpool John Moores University, Liverpool, UK
| | - D Kissane
- Department of Psychiatry, Monash University and Monash Medical Centre, Monash Health, Clayton, Australia
| | - G Rodin
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Canada
| | - D McFarland
- Department of Psychiatry, University of Rochester, Rochester; Wilmont Cancer Institute, University of Rochester Medical Center, Rochester, USA
| | - R Campos-Ródenas
- Department of Psychiatry, Hospital Clínico Universitario Lozano Blesa, University of Zaragoza, Zaragoza, Spain
| | - R Zachariae
- Unit for Psychooncology and Health Psychology, Department of Oncology, Aarhus University Hospital, Aarhus; Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - D Santini
- UOC Medical Oncology, AUSL Latina, Sapienza University of Rome, Aprilia
| | - C I Ripamonti
- Oncology-Supportive Care in Cancer, Department of Oncology & Haematology Fondazione IRCCS, Istituto Nazionale dei Tumori di Milano, Milan, Italy
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19
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Moureau L, Verhofstadt M, Liégeois A. Mapping the ethical aspects in end-of-life care for persons with a severe and persistent mental illness: A scoping review of the literature. Front Psychiatry 2023; 14:1094038. [PMID: 37009126 PMCID: PMC10062453 DOI: 10.3389/fpsyt.2023.1094038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/20/2023] [Indexed: 03/18/2023] Open
Abstract
Persons with severe and persistent mental illness (SPMI) make up a vulnerable group within mental healthcare and society. Not only do they suffer from long-term, serious psychiatric disorders; they often also experience considerable problems in their psychosocial functioning. Research has disclosed that the care needs of this target group are complex, and that the life expectancy of these persons is significantly lower than in the general population. Given (1) the lower life expectancy of persons with SPMI, (2) the higher suicide risk related to mental disorders, and (3) the legalization and practice of medical assistance in dying in an increasing number of countries, it is of utmost importance to map the ethical aspects and challenges of end-of-life care needs in persons with SPMI. Therefore, we charted the way end-of-life care is provided for them by means of a scoping review of the scientific literature, with an emphasis on the ethical aspects surrounding it. We explore existing ethical dilemmas; the underlying ethical values, principles and attitudes; and the locus and stakeholders of ethical dialog regarding end-of-life care in persons with SPMI. The results indicate that the four guiding principles of biomedical ethics can well be identified in the literature, and are each addressed in their own specific way: Autonomy in relation to questions regarding the decision-making capacity of persons with SPMI; Justice in relation to access to quality care and the presence of stigma; and Non-maleficence and Beneficence in relation to the ongoing debate regarding the benefits and obstacles in applying palliative care approaches in the context of psychiatry, and the status of the futility-concept therein. Personal virtues and attitudes in care professionals, like compassion, non-abandonment and upholding dignity are key, as care professionals are the main advocates of persons with SPMI, which often lack an extensive social network. Further, we find that the ethical dialog is mainly focused on care professionals and relatives, rather than the persons with SPMI themselves. This is reflected in the existing research that often had the voices of the latter missing. Future research may benefit from the inclusion of persons with SMPI’s first-hand accounts. End-of-life care for persons with SPMI may benefit from identifying and integrating (locally developed) good practices like cross-sectoral education, specific care models, and ethics support.
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Affiliation(s)
- Loïc Moureau
- Faculty of Theology and Religious Studies, KU Leuven, Leuven, Belgium
- *Correspondence: Loïc Moureau,
| | - Monica Verhofstadt
- Medical and Health Sciences, Ghent University, Ghent, East Flanders, Belgium
| | - Axel Liégeois
- Faculty of Theology and Religious Studies, KU Leuven, Leuven, Belgium
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20
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Wang YH, Aggarwal A, Stewart R, Davies EA. Impact of pre-existing mental health disorders on the receipt of guideline recommended cancer treatments: A systematic review. Psychooncology 2023; 32:307-330. [PMID: 36588188 DOI: 10.1002/pon.6081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 12/22/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Disparities in cancer outcomes for individuals with pre-existing mental health disorders have already been identified, particularly for cancer screening and mortality. We aimed to systematically review the influence on the time from cancer diagnosis to cancer treatment, treatment adherence, and differences in receipt of guideline recommended cancer treatment. METHODS We included international studies published in English from 1 January 1995 to 23 May 2022 by searching MEDLINE, Embase, and APA PsycInfo. RESULTS This review identified 29 studies with 27 being published in the past decade. Most studies focused on breast, non-small cell lung and colorectal cancer and were of high or medium quality as assessed by the Newcastle Ottawa Scale. All studies were from high-income countries, and mostly included patients enrolled in national health insurance systems. Five assessed the impact on treatment delay or adherence, and 25 focused on the receipt of guideline recommended treatment. 20/25 studies demonstrated evidence that patients with pre-existing mental health disorders were less likely to receive guideline recommended therapies such as surgery or radiotherapy. In addition, there was a greater likelihood of receiving less intensive or modified treatment including systemic therapy. CONCLUSIONS Across different cancer types and treatment modalities there is evidence of a clear disparity in the receipt of guideline recommended cancer treatment for patients with pre-existing mental health disorders. The effect of pre-existing mental health disorders on treatment delay or adherence is under-researched. Future research needs to include low- and middle-income countries as well as qualitative investigations to understand the reasons for disparities in cancer treatment.
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Affiliation(s)
- Yueh-Hsin Wang
- Cancer Epidemiology and Cancer Services Research, Centre for Cancer Society & Public Health, Comprehensive Cancer Centre, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Ajay Aggarwal
- Institute of Cancer Policy, King's College London, London, UK
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Robert Stewart
- South London and Maudsley NHS Foundation Trust, London, UK
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Elizabeth A Davies
- Cancer Epidemiology and Cancer Services Research, Centre for Cancer Society & Public Health, Comprehensive Cancer Centre, Faculty of Life Sciences & Medicine, King's College London, London, UK
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21
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Deshields T, Asvat Y. The Case for Accelerating Integrated Mental Health Care in the Cancer Setting. JCO Oncol Pract 2023; 19:231-233. [PMID: 36800568 DOI: 10.1200/op.22.00840] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
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22
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Bergerot CD, Dizon DS, Ilbawi AM, Anderson BO. Global Breast Cancer Initiative: A platform to address the psycho-oncology of cancer in low- and middle-income countries for improving global breast cancer outcomes. Psychooncology 2023; 32:6-9. [PMID: 36468340 DOI: 10.1002/pon.5969] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Psycho-oncology is a clinical specialty in which the humanistic aspects of cancer diagnoses and treatment are addressed to reduce the psychological burden for patients and their caregivers to optimize patient participation, cancer outcomes and quality-of-life, which is especially critical in cultures where cancer is perceived as invariably fatal. Psycho-oncology programs face multiple barriers in low- and middle-income countries, including limited resource allocation and lack of training, both of which have been impediments to psycho-oncology programs becoming recognized as core competencies in cancer management and part of a standard medical curriculum. PURPOSE This paper discusses the role of the Global Breast Cancer Initiative (GBCI) in helping to overcome inequities in breast cancer care and improve clinical outcomes from a psycho-oncology perspective as a model for improved cancer care in limited resource settings. FINDINGS GBCI applies a comprehensive framework encompassing all phases of cancer care (defined through three pillars spanning the continuum of cancer management) and includes addressing the physical, psychological, and social needs of women throughout the life-course. Efforts to promote policies that increase access to early detection and treatment programs and improve health literacy among the public are important strategies to mitigate the most common emotional and physical challenges reported by people with cancer accessing care. CONCLUSIONS Future efforts will focus on the integration of culturally appropriate guidance to promote early cancer detection and treatment completion through training programs for clinicians to establish core competencies in psycho-oncology. Emerging advocacy efforts in the oncology arena may help guide the integration of psycho-oncology services into routine care in countries where these services are not already integrated into the standard curriculum.
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Affiliation(s)
- Cristiane Decat Bergerot
- Centro de Câncer de Brasília, Instituto Unity de Ensino e Pesquisa, Brasília, Distrito Federal, Brazil
| | - Don S Dizon
- Brown University, Lifespan Cancer Institute, Providence, Rhode Island, USA
| | - Andre M Ilbawi
- Department of Noncommunicable Diseases, World Health Organization (WHO), Geneva, Switzerland
| | - Benjamin O Anderson
- Department of Noncommunicable Diseases, World Health Organization (WHO), Geneva, Switzerland.,Departments of Surgery and Global Health-Medicine, University of Washington, Seattle, Washington, USA
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23
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Cancer mortality in Common Mental Disorders: A 10-year retrospective cohort study. Soc Psychiatry Psychiatr Epidemiol 2023; 58:309-318. [PMID: 36394636 PMCID: PMC9922233 DOI: 10.1007/s00127-022-02376-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 10/28/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE Individuals with Common Mental Disorders (CMDs) may have a higher cancer mortality. The purpose of this study was to examine cancer-related mortality among patients with CMDs and verify which cancer types are predominantly involved. METHODS We used the Regional Mental Health Registry of the Emilia-Romagna region, in Northern Italy to identify patients aged ≥ 18 years who received an ICD 9-CM diagnosis of CMDs (i.e., depressive and neurotic disorders) over a 10 year period (2008-2017). Information on cause of death was retrieved from the Regional Cause of Death Registry. Comparisons were made with data from the regional population without CMDs. RESULTS Among 101,487 patients suffering from CMDs (55.7% depression; 44.3% neurotic disorders), 3,087 (37.8%) died from neoplasms. The total standardized mortality ratio (SMR) was 1.82 (95% CI 1.78-1.86) while the SMR for all neoplasms was 2.08 (95% CI 2.01-2.16). Individuals of both genders, with both depressive and neurotic disorders had a higher risk of death from almost all cancers compared with the regional population. CONCLUSION Patients with CMDs have considerably higher cancer mortality risk than the general population. Higher mortality was observed for a broad range of cancers associated with different aetiologies. It is imperative to promote cancer awareness, prevention and treatment for people with CMDs.
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Mortality in Schizophrenia-Spectrum Disorders: Recent Advances in Understanding and Management. Healthcare (Basel) 2022; 10:healthcare10122366. [PMID: 36553890 PMCID: PMC9777663 DOI: 10.3390/healthcare10122366] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022] Open
Abstract
Schizophrenia is a life-shortening disease and life expectancy in patients may be 15-20 years shorter than in the general population, with increasing longevity gap over time. Premature mortality in schizophrenia-spectrum disorders is mainly due to preventable natural causes, such as cardio-vascular disease, infections, respiratory tract diseases and cancer, alongside suicide, homicide and accidents. There is a complex interplay of factors that act synergistically and cause physical morbidity to patients and subsequent mortality. Smoking, alcohol/substance abuse and sedentary life style, alongside disease-related factors, such as metabolic abnormalities and accelerating aging contribute to physical morbidity. Moreover, the symptomatology of psychosis and stigma may limit patients' access to quality medical care. Interventions to promote physical health in those patients should be multifaceted, and should target all patient-related modifiable factors, but also should address service-related healthcare disparities. Long-term antipsychotic use (including clozapine and long-acting injectables) is associated with substantially decreased all-cause mortality, including suicide and cardiovascular mortality, in patients with schizophrenia despite the well-known cardiometabolic adverse effects of second-generation agents. Integrated care may involve co-location of physical and mental health services, liaison services, shared protocols and information sharing systems, and has emerged as a way to address the physical health needs of those patients. Interventions to address mortality in schizophrenia and related syndromes should take place as early as possible in the course of the patients' treatment, and could be an integral component of care delivered by specialized early intervention services.
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Boschen K, Phelan C, Lawn S. NDIS Participants with Psychosocial Disabilities and Life-Limiting Diagnoses: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10144. [PMID: 36011776 PMCID: PMC9407781 DOI: 10.3390/ijerph191610144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
This research aimed to map evidence about system supports and gaps for Australians with psychosocial disabilities and life-limiting diagnoses. A scoping review of available policy documents, academic, and grey literature was completed to discover key characteristics of this concept and provide context around the phenomenon. Our focus was on Australia's National Disability Insurance Scheme (NDIS), a key reform providing support to the disability population nationally. No peer-reviewed or grey literature was retrieved on the phenomena. Therefore, three lines of enquiry were developed: experiences of NDIS participants living with psychosocial disabilities; the death, dying, and palliative care supports and experiences of NDIS participants of any disability type; and the experiences for people living with severe and persistent mental illness (SPMI) and life-limiting diagnoses. Five themes were identified: (1) the person; (2) advocacy; (3) informal supports; (4) formal supports; and (5) existing research. NDIS participants living with SPMI and their informal and formal support systems are still struggling to navigate the NDIS. While there are no specific publications about their end-of-life experiences, people with SPMI often experience poor end-of-life outcomes. Rigorous research into their death, dying, and palliative care experiences is needed to inform improved support to them, including their end-of-life care.
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Affiliation(s)
- Kathy Boschen
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5050, Australia
| | - Caroline Phelan
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5050, Australia
| | - Sharon Lawn
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5050, Australia
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Lázaro-Sánchez AD, Juárez Marroquí A, Quesada Rico JA, Orozco-Beltrán D. Risk Factors for Cancer Mortality in Spain: Population-Based Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9852. [PMID: 36011484 PMCID: PMC9408698 DOI: 10.3390/ijerph19169852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/07/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Cancer is considered a major public health problem due to its increasing incidence and high mortality. This study aims to identify risk factors for cancer mortality in Spain. METHODS Retrospective population-based cohort study in 20,397 participants of the 2011/2012 National Health Survey in Spain. Risk factors associated with mortality due to neoplasm from 2011 to 2017 were analyzed, and hazard ratios were calculated with a multivariate Cox model with competing risks for mortality from other causes. RESULTS Myocardial infarction, chronic obstructive pulmonary disease, cirrhosis, and mental disorders were associated with an increased risk of mortality due to neoplasm. Male sex, age over 50 years, history or current smoking habit, negligible intake of legumes, and poorer self-perceived health were also associated with increased cancer mortality. CONCLUSIONS Comorbidities, tobacco use, poor diet, and worse self-perceived health were the main risk factors for cancer mortality in Spain.
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Affiliation(s)
- Antonio D. Lázaro-Sánchez
- Medical Oncology Service, University Hospital of Sant Joan d’Alacant, 03550 Sant Joan d’Alacant, Spain
| | - Asunción Juárez Marroquí
- Medical Oncology Service, University Hospital of Sant Joan d’Alacant, 03550 Sant Joan d’Alacant, Spain
| | - Jose Antonio Quesada Rico
- Department of Clinical Medicine, University Miguel Hernández de Elche, Ctra. Nnal. 332, s/n, 03202 Elche, Spain
| | - Domingo Orozco-Beltrán
- Department of Clinical Medicine, University Miguel Hernández de Elche, Ctra. Nnal. 332, s/n, 03202 Elche, Spain
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27
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Arevalo M, Pickering TA, Vernon SW, Fujimoto K, Peskin MF, Farias AJ. Do breast cancer survivors with a recent history of clinical depression report worse experiences with care? A retrospective cohort study using SEER-CAHPS data. Cancer Med 2022; 12:1949-1960. [PMID: 35929584 PMCID: PMC9883547 DOI: 10.1002/cam4.5031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/26/2022] [Accepted: 06/29/2022] [Indexed: 02/02/2023] Open
Abstract
PURPOSE We examined whether breast cancer survivors' experiences with care differed by a recent history of clinical depression, and whether associations differed by race/ethnicity. METHODS Using the Epidemiology and End Results-Consumer Assessment of Healthcare Providers and Systems (SEER-CAHPS) dataset, we analyzed records of breast cancer survivors who completed a survey at least 12 months after their cancer diagnosis. We assessed clinical depression 12 months prior to survey completion using Medicare claims. We used separate multivariable logistic regressions to examine the associations between depression and excellent (vs. less than excellent) ratings of experiences with care (i.e., doctor communication, getting needed care, getting care quickly, getting prescription drugs, specialist and overall care). We also assessed interactions of depression by race/ethnicity. All models were adjusted for demographics and cancer prognostic and treatment factors. RESULTS Of the 2271 survivors, 7.6% were clinically depressed. After adjusting for covariates, survivors with clinical depression had lower odds of reporting excellent ratings of their ability to get needed care, care by their specialist, and overall care, compared to those without depression (AOR = 0.58, 95% CI: 0.40-0.84; AOR = 0.40, CI: 0.31-0.76; and AOR = 0.61, CI: 0.42-0.89, respectively). Among Hispanics, having depression was associated with higher odds of excellent ratings of one's ability to get needed care (AOR: 5.42, 95% CI: 1.02-28.81). No other statistically significant associations by race/ethnicity were found. CONCLUSIONS Breast cancer survivors with depression report poorer patient experiences with care. Further research is needed to understand complexities of ratings of experiences with care among survivors of diverse backgrounds. IMPLICATIONS Survivors with a recent history of clinical depression may benefit from additional supportive care services.
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Affiliation(s)
- Mariana Arevalo
- Department of Health Promotion & Behavioral SciencesSchool of Public Health, The University of Texas Health Science Center at Houston (UTHealth)HoustonTexasUSA
| | - Trevor A. Pickering
- Department of Preventive MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Sally W. Vernon
- Department of Health Promotion & Behavioral SciencesSchool of Public Health, The University of Texas Health Science Center at Houston (UTHealth)HoustonTexasUSA
| | - Kayo Fujimoto
- Department of Health Promotion & Behavioral SciencesSchool of Public Health, The University of Texas Health Science Center at Houston (UTHealth)HoustonTexasUSA
| | - Melissa F. Peskin
- Department of Health Promotion & Behavioral SciencesSchool of Public Health, The University of Texas Health Science Center at Houston (UTHealth)HoustonTexasUSA
| | - Albert J. Farias
- Department of Preventive MedicineKeck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaUSA,Gehr Family Center for Health System ScienceKeck School of Medicine of the University of Southern CaliforniaLos AngelesCaliforniaUSA,Cancer Control Research ProgramUniversity of Southern California Norris Comprehensive Cancer CenterLos AngelesCaliforniaUSA
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28
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Pergolizzi JV, Magnusson P, Christo PJ, LeQuang JA, Breve F, Mitchell K, Varrassi G. Opioid Therapy in Cancer Patients and Survivors at Risk of Addiction, Misuse or Complex Dependency. FRONTIERS IN PAIN RESEARCH (LAUSANNE, SWITZERLAND) 2022; 2:691720. [PMID: 35295520 PMCID: PMC8915703 DOI: 10.3389/fpain.2021.691720] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 10/13/2021] [Indexed: 12/21/2022]
Abstract
A clinical conundrum can occur when a patient with active opioid use disorder (OUD) or at elevated risk for the condition presents with cancer and related painful symptoms. Despite earlier beliefs that cancer patients were relatively unaffected by opioid misuse, it appears that cancer patients have similar risks as the general population for OUD but are more likely to need and take opioids. Treating such patients requires an individualized approach, informed consent, and a shared decision-making model. Tools exist to help stratify patients for risk of OUD. While improved clinician education in pain control is needed, patients too need to be better informed about the risks and benefits of opioids. Patients may fear pain more than OUD, but opioids are not always the most effective pain reliever for a given patient and some patients do not tolerate or want to take opioids. The association of OUD with mental health disorders (dual diagnosis) can also complicate delivery of care as patients with mental health issues may be less adherent to treatment and may use opioids for “chemical coping” as much as for pain control.
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Affiliation(s)
| | - Peter Magnusson
- Centre for Research & Development, Uppsala University, Uppsala, Sweden.,Department of Medicine, Cardiology Research Unit, Karolinska Institutet, Stockholm, Sweden
| | - Paul J Christo
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | | | - Frank Breve
- Department of Pharmacy Practice, Temple University School of Pharmacy, Philadelphia, PA, United States
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Günther MP, Schulze JB, Kirchebner J, Jordan KD, von Känel R, Euler S. Severe mental illness in cancer is associated with disparities in psycho-oncological support. Curr Probl Cancer 2022; 46:100849. [DOI: 10.1016/j.currproblcancer.2022.100849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/11/2022] [Accepted: 02/17/2022] [Indexed: 11/03/2022]
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Taylor-Desir MJ, Sawchuk CN, Crane SJ, Carroll JL, Evans WS, Bogucki OE, Lewis SE, Lapid MI. Integration of Mental Health and Supportive Care in Individuals with Schizophrenia and Cancer: Assertive Community Treatment Model. Psychooncology 2022. [PMID: 35212429 DOI: 10.1002/pon.5911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 01/25/2022] [Accepted: 02/21/2022] [Indexed: 12/24/2022]
Abstract
This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
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Affiliation(s)
| | - Craig N Sawchuk
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Sarah J Crane
- Division of Community Internal Medicine, Mayo Clinic, Rochester, MN
| | | | - Whitney S Evans
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Olivia E Bogucki
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Susan E Lewis
- Adult and Family Services, Olmsted County, Rochester, MN
| | - Maria I Lapid
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
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Forward to a methodological proposal to support cancer patients: the dialogics' contribution for the precision care. Med Oncol 2022; 39:75. [PMID: 35195776 DOI: 10.1007/s12032-021-01644-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 12/30/2021] [Indexed: 10/19/2022]
Abstract
In scientific context, the first step for scientific theoretical and methodological production is the epistemological analysis. What are assumptions for interaction between oncology and psychology? What are the conditions for psycho-oncological contribution in treating cancer? Furthermore, what are epistemological observations about the current developments in cancer field? And what are implications for sciences treating patients with neoplasms? Due to advances in oncology and in sciences supporting oncology, epistemological questions focus on the object of study of the integration between oncology and psychology. Therefore, the purpose of this study is to describe a proposal of theoretical and methodological frame suitable for current clinical and research needs in cancer patients asking for psychological support. Epistemological analysis lets the health professionals and researchers observe there are sciences using formal languages and sciences using ordinary language. Currently, personalized approach is pursued by oncology, identifying specific patients' characteristics to define the proper treatment process: not only tumor characteristics but also behavioral and psychological features. Cancer patients features can be found in patients' narrations about neoplasms: narration represents the core of clinical and research in psychoncology. Therefore when formalized, language provides the connection between oncology and psychology. Language used by patients and all the roles involved in the care of cancer patients can become a measure of these patients' features. Dialogics science measuring the ordinary language allows the ordinary language formalization, pursuing a personalized medicine.
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32
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Lindert J, Sancassiani F, Massa E, Nardi AE. An Overview of the International Literature on Health-Related Quality of Life, Mental Health and Psychosocial Issues in People with Cancer. Clin Pract Epidemiol Ment Health 2021; 17:253-256. [PMID: 35444711 PMCID: PMC8985473 DOI: 10.2174/1745017902117010253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background Cancer is one of the most important leading causes of death worldwide. Early detection, screening and diagnosis have been demonstrated to significantly improve patients' survival rates and increase awareness of the benefit of prompt therapies and healthy lifestyles. In this context, Health-related Quality of Life (HRQoL) and several psychosocial difficulties are of relevance as prognostic factors for the trajectory of the diseases of people living with cancer. Methods This Special Issue aims to present a set of systematic reviews and research studies focusing on several psychosocial aspects in people suffering from hematologic and solid cancer. Results Three systematic reviews regard HRQoL, the quality of patient-physician communication, depression and other stress-related difficulties, respectively. One review pointed out the difficulties in diagnosing depression in the elderly with solid cancer; another one regards the risk of cancer in severe mental illnesses, such as schizophrenia, bipolar disorders, and severe depressive disorders. One additional review regards HRQoL in people with cancer in the present era of COVID-19 pandemic. Furthermore, some research studies pointed out the usefulness of a validated instrument to assess satisfaction with care in the oncology field, as well as of the self-reinforcing feedback loop to improve fatigue, insomnia and depression in people with cancer. Other two research studies evaluate, respectively, the attributable burden in worsening HRQoL in people suffering both from cancer and depression and the Type D personality as a risk factor for stress-related difficulties in women with breast cancer. Conclusion This Special Issue is a contribution to enhance future research mainly about such interventions useful to assess and improve HRQoL and overall well-being in people with cancer.
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Affiliation(s)
- Jutta Lindert
- University of Applied Sciences Emden/Leer, Emden, Germany; WRSC, Brandeis University, Waltham, United States
| | - Federica Sancassiani
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy,Address correspondence to this author at Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Tel: 0039 3493119215; E-mail:
| | - Elena Massa
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Antonio Egidio Nardi
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Grassi L, Riba MB. Disparities and inequalities in cancer care and outcomes in patients with severe mental illness: Call to action. Psychooncology 2021; 30:1997-2001. [PMID: 34874094 DOI: 10.1002/pon.5853] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVES People with severe mental illness (SMI) are at extreme risk of being stigmatized and to receive poor quality physical care. It has been demonstrated that they have higher morbidity and poorer prognosis of several medical diseases than the general population, with an at least 10-20-year reduction in life expectancy. METHODS A special issue of Psycho-Oncology focusing on cancer care among patients affected by SMI was called by the Editorial Board of the journal, with the aim to explore cancer health disparities and inequalities among people with SMI, mortality from cancer, problems of communication between multidisciplinary oncology and psychiatric teams and need for more structured intervention (i.e., screening, prevention, treatment). RESULTS Authors from eight countries contributed. The problem of stigma and barriers to cancer care provision for patients with SMI were studied (e.g., the complex nature of SMI and healthcare providers' misunderstanding of SMI). Key barriers were related to both patients, clinicians and institutional problems, such as fragmentation of care. A higher mortality from cancer and poor knowledge about cancer risk-factors was shown in patients with SMI. Models of intervention were also proposed. CONCLUSIONS Several conclusions have been recommended by the authors, such as the need for guidelines and clinical procedures specific for cancer care in mental health settings; large-scale studies to address the disparities of care in people with SMI; a larger vision of psychosocial oncology as the facilitator of the liaison between oncology and psychiatry.
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Affiliation(s)
- Luigi Grassi
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy.,University Hospital Psychiatric Unit, S. Anna Hospital, Ferrara, Italy.,Local Health Trust, Ferrara, Italy
| | - Michelle B Riba
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.,Psychoncology Program, University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, USA
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Leahy D, Donnelly A, Irwin K, D'Alton P. Barriers and facilitators to accessing cancer care for people with significant mental health difficulties: A qualitative review and narrative synthesis. Psychooncology 2021; 30:2012-2022. [PMID: 34747534 DOI: 10.1002/pon.5848] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 10/22/2021] [Accepted: 10/26/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Inequities in cancer care contribute to higher rates of cancer mortality for individuals with significant mental health difficulties (SMHD) compared to the general population. The aim of the current systematic review was to identify, appraise and synthesise qualitative evidence of patient and clinician/system barriers and facilitators to cancer screening and treatment for individuals with SMHD. METHODS We conducted a systematic search across three electronic databases in May 2020 and we carried out a second search across five electronic databases in January 2021. A narrative synthesis was conducted across eligible studies. RESULTS We identified the same six studies from both searches, with 133 individuals with SMHD and experiences of cancer care and 102 healthcare professionals. Key barriers to cancer care were related to patients' uncontrolled psychiatric symptoms and the adverse impact of their symptoms on engaging with cancer care; clinician barrier-attitudes included stigmatising attitudes from clinicians and other staff towards individuals with SMHD and systems barrier-fragmentation included the fragmentation of mental health and cancer care delivery. Key patient facilitators to accessing cancer care and completing cancer treatment included being connected with mental health services and controlled psychiatric symptoms. Stronger collaboration among healthcare professionals working across different sectors in addition to the development of a patient navigator role were identified as key facilitators to enhance patient care. CONCLUSIONS Innovative approaches are needed to decrease mental health stigma, foster collaboration across disciplines, and facilitate the integration of timely mental health and cancer care for individuals with SMHD to address the mortality gap.
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Affiliation(s)
- Dorothy Leahy
- Doctoral Programme in Clinical Psychology, School of Psychology, University College Dublin, Dublin, Ireland
| | - Alanna Donnelly
- Doctoral Programme in Clinical Psychology, School of Psychology, University College Dublin, Dublin, Ireland
| | - Kelly Irwin
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital Cancer Center, Boston, Massachusetts, USA
| | - Paul D'Alton
- Doctoral Programme in Clinical Psychology, School of Psychology, University College Dublin, Dublin, Ireland
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Rhee SJ, Lee H, Ahn YM. Association between serum uric acid and depressive symptoms stratified by low-grade inflammation status. Sci Rep 2021; 11:20405. [PMID: 34650110 PMCID: PMC8516956 DOI: 10.1038/s41598-021-99312-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 09/21/2021] [Indexed: 02/04/2023] Open
Abstract
Despite increasing evidence for an association between circulating uric acid (UA) and depression, the directionality of this association remains unclear and is potentially moderated by low-grade inflammation. Thus, the present study aimed to investigate the cross-sectional association between serum UA concentration and depressive symptoms in Korean individuals with and without low-grade inflammation, as measured using serum high-specific C-reactive protein (hs-CRP) levels. The final study sample comprised 4188 participants, aged 19–79 years, from the Korea National Health and Nutrition Examination Study 2016. Data on serum uric acid (UA) concentrations, serum hs-CRP levels, Patient Health Questionnaire-9 (PHQ-9) scores, and relative covariates were retrieved. Negative binomial regression with adjustment for the complex sample design was used to analyze the associations. After adjusting for covariates, log-transformed serum UA concentrations and total PHQ-9 scores were positively associated (incidence rate ratio [IRR] = 1.34 [95% confidence interval [CI] = 1.09–1.66]) for participants without low-grade inflammation and inversely associated (IRR = 0.64 [95% CI = 0.45–0.92]) for participants with low-grade inflammation. In conclusion, the direction of the association between serum UA and depressive symptoms was the opposite in participants with and without low-grade inflammation. The study has the limitation of potential uncontrolled confounders.
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Affiliation(s)
- Sang Jin Rhee
- Department of Neuropsychiatry, Seoul National University Hospital, 28 Yongon-Dong, Chongno-gu, Seoul, 03080, Republic of Korea
| | - Hyunju Lee
- Department of Neuropsychiatry, Seoul National University Hospital, 28 Yongon-Dong, Chongno-gu, Seoul, 03080, Republic of Korea.,Department of Psychiatry, Seoul National University College of Medicine, 28 Yongon-Dong, Chongno-gu, Seoul, 03080, Republic of Korea
| | - Yong Min Ahn
- Department of Neuropsychiatry, Seoul National University Hospital, 28 Yongon-Dong, Chongno-gu, Seoul, 03080, Republic of Korea. .,Department of Psychiatry, Seoul National University College of Medicine, 28 Yongon-Dong, Chongno-gu, Seoul, 03080, Republic of Korea. .,Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, 28 Yongon-Dong, Chongno-gu, Seoul, 03080, Republic of Korea.
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Grassi L, Caruso R, Biancosino B, Belvederi Murri M, Riba M, Meggiolaro E, Ruffilli F, Palagini L, Nanni MG, Zavatta S, Toffanin T, Folesani F, Zerbinati L. Knowledge about risk factors for cancer and cancer risk behavior among patients with severe mental illness. Psychooncology 2021; 30:2077-2081. [PMID: 34546609 PMCID: PMC9291283 DOI: 10.1002/pon.5822] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/03/2021] [Accepted: 09/05/2021] [Indexed: 12/02/2022]
Abstract
Objective To examine knowledge about, perception of and current risk factors for cancer, among patients with severe mental illness (SMI) and to compare these variables with patients without SMI. Methods A series of patients affected by SMI (i.e., schizophrenia spectrum disorders, bipolar disorders and severe personality disorders) and a matched (gender, age) control group of primary care attenders were assessed, by using an ad hoc semi‐structured interview and a short true/false 17‐item questionnaire, about family history of cancer, cancer risk‐related lifestyles, personal perception and knowledge of risk for cancer. Results Patients with SMI (n = 185, mainly schizophrenia spectrum disorders, 48%, and mood disorders, 33%) significantly differed from primary care attenders (n = 173) for: lower participation to occult stool blood screening test, Pap smear test and mammography; higher prevalence of current and past smoking habits; lower awareness towards their own physical symptoms and their perception of risks for cancer; lower physical exercise practicing; lower knowledge about risk factors for cancer (e.g. familiarity for cancer, smoke‐habits, breast and uterine cancer). Conclusions Patients suffering from SMI had higher at‐risk behavior for cancer and showed fewer concerns and less knowledge about risk for cancer than primary care attendees. These findings can guide to implement screening for cancer (e.g., Pap test, blood) and to design evidence‐based interventions to reduce cancer risk (e.g., educational and behavioral change for smoking cessation, dietary habits) among patients with SMI.
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Affiliation(s)
- Luigi Grassi
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Rosangela Caruso
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Bruno Biancosino
- Integrated Department of Mental Health and Pathological Addictions, Local Health Trust, Ferrara, Italy
| | - Martino Belvederi Murri
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Michelle Riba
- Department of Psychiatry, University of Michigan, University of Michigan Rogel Cancer Center, Ann Arbor, MI, USA
| | - Elena Meggiolaro
- IRCCS Istituto Romagnolo Per Lo Studio Dei Tumori, Psycho-Oncology Unit, Meldola, Italy
| | - Federica Ruffilli
- IRCCS Istituto Romagnolo Per Lo Studio Dei Tumori, Psycho-Oncology Unit, Meldola, Italy
| | - Laura Palagini
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Maria Giulia Nanni
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Sara Zavatta
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Tommaso Toffanin
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Federica Folesani
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Luigi Zerbinati
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
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Grassi L, Stivanello E, Belvederi Murri M, Perlangeli V, Pandolfi P, Carnevali F, Caruso R, Saponaro A, Ferri M, Sanza M, Fioritti A, Meggiolaro E, Ruffilli F, Nanni MG, Ferrara M, Carozza P, Zerbinati L, Toffanin T, Menchetti M, Berardi D. Mortality from cancer in people with severe mental disorders in Emilia Romagna Region, Italy. Psychooncology 2021; 30:2039-2051. [PMID: 34499790 PMCID: PMC9290959 DOI: 10.1002/pon.5805] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 08/17/2021] [Accepted: 08/20/2021] [Indexed: 11/11/2022]
Abstract
Objective To examine cancer‐related mortality in patients with severe mental disorders (SMI) in the Emilia Romagna (ER) Region, Northern Italy, during the period 2008–2017 and compare it with the regional population. Methods We used the ER Regional Mental Health Registry identifying all patients aged ≥18 years who had received an ICD‐9CM system diagnosis of SMI (i.e., schizophrenia or other functional psychosis, mania, or bipolar affective disorders) during a 10‐year period (2008–2017). Information on deaths (date and causes of death) were retrieved through the Regional Cause of Death Registry. Comparisons were made with the deaths and cause of deaths of the regional population over the same period. Results Amongst 12,385 patients suffering from SMI (64.1% schizophrenia spectrum and 36.9% bipolar spectrum disorders), 24% (range 21%–29%) died of cancer. In comparison with the general regional population, the mortality for cancer was about 50% higher among patients with SMI, irrespective if affected by schizophrenia or bipolar disorders. As for the site‐specific cancers, significant excesses were reported for stomach, central nervous system, respiratory, and pancreas cancer with a variability according to psychiatric diagnosis and gender. Conclusions Patients suffering from SMI had higher mortality risk than the regional population with some differences according to cancer type, gender, and psychiatric diagnosis. Proper cancer preventive and treatment interventions, including more effective risk modification strategies (e.g., smoking cessation, dietary habits) and screening for cancer, should be part of the agenda of all mental health departments in conjunction with other health care organizations, including psycho‐oncology.
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Affiliation(s)
- Luigi Grassi
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Elisa Stivanello
- Department of Public Health, Local Health Trust of Bologna, Bologna, Italy
| | - Martino Belvederi Murri
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | | | - Paolo Pandolfi
- Department of Public Health, Local Health Trust of Bologna, Bologna, Italy
| | - Fabio Carnevali
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Rosangela Caruso
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Alessio Saponaro
- General Directorate of Health and Social Policies, Bologna, Italy
| | - Mila Ferri
- General Directorate of Health and Social Policies, Bologna, Italy
| | - Michele Sanza
- Department of Mental Health and Substance Abuse, Local Health Trust of Romagna, Cesena, Italy
| | - Angelo Fioritti
- Department of Mental Health and Substance Abuse, Local Health Trust of Bologna, Bologna, Italy
| | - Elena Meggiolaro
- Psycho-Oncology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Federica Ruffilli
- Psycho-Oncology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Maria Giulia Nanni
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Maria Ferrara
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy.,Department of Psychiatry, Yale University, School of Medicine, New Haven, Connecticut, USA.,Program for Specialized Treatment Early in Psychosis (STEP), Connecticut Mental Health Center, New Haven, Connecticut, USA
| | - Paola Carozza
- Integrated Department of Mental Health and Pathological Addictions, Local Health Trust of Ferrara, Ferrara, Italy
| | - Luigi Zerbinati
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Tommaso Toffanin
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
| | - Marco Menchetti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Domenico Berardi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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Park SJ, Wai A, Pavithran K, Kunheri B, Valsraj K. Cancer and severe mental illness in low- and middle-income countries: The challenges and outlook for the future. Psychooncology 2021; 30:2002-2011. [PMID: 34449954 DOI: 10.1002/pon.5796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/18/2021] [Accepted: 08/09/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Patients with severe mental illness (SMI) face health inequalities that lead to under treatment of diseases such as cancer and result in increased mortality. There is literature addressing this issue for SMI patients in high-income countries but few for those in low- and middle-income countries. This review aims to draw attention to the health inequalities and the compounding factors faced by SMI patients in low- and middle-income countries. The relevance of integration of psycho-oncology in the care of SMI patients with cancer is integral to reduce disparities and address varied contributory factors. METHODS The literature review was conducted by searching through two databases which includes PubMed and Google Scholar. We searched for articles using keyword search terms: severe mental illness, SMI, schizophrenia, bipolar disorder, cancer, low- middle-income countries, low- and middle-income countries, psycho-oncology, HPV vaccine, cancer incidence, cancer mortality, cancer control, cancer screening, cancer treatment and palliative care. RESULTS A total of 80 research articles were included in our literature review. We found that there was an increased requirement for adapting to the changing disease landscape in low- and middle-income countries. An improvement on aspects such as vaccination, screening and prevention is necessary, and also efforts to change social stance towards SMI is crucial. CONCLUSION There is an increase incidence of cancer in low- and middle-income countries, and the number of patients with SMI in low- and middle-income countries is also rising. This is due to social, psychological, economical and healthcare factors. Low- and middle-income countries must consider improving these aspects in order to adapt to the changing landscape.
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Affiliation(s)
- Sung Jin Park
- Department of Academic Psychiatry, Institute of Psychiatry, Psychology and Neurosciences at King's College London, London, UK
| | - Alisa Wai
- Department of Academic Psychiatry, Institute of Psychiatry, Psychology and Neurosciences at King's College London, London, UK
| | - Keechilat Pavithran
- Department of Medical Oncology, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, India
| | | | - Koravangattu Valsraj
- Department of Academic Psychiatry, Institute of Psychiatry, Psychology and Neurosciences at King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
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Etoh T, Fujiwara M, Yamada Y, Wada R, Higuchi Y, Inoue S, Kodama M, Matsushita T, Yoshimura Y, Horii S, Fujimori M, Kakeda K, Shimazu T, Nakaya N, Tabata M, Uchitomi Y, Yamada N, Inagaki M. Cancer care for people with mental disorders: A qualitative survey among cancer care and psychiatric care professionals in Japan. Psychooncology 2021; 30:2060-2066. [PMID: 34435715 DOI: 10.1002/pon.5780] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/29/2021] [Accepted: 07/22/2021] [Indexed: 01/05/2023]
Abstract
OBJECTIVE It is widely assumed that there are multiple levels (from individual to policy level) of problems involving disparities in cancer care for people with mental disorders. However, few studies have comprehensively investigated issues as perceived by medical professionals. The purpose of the present study was to identify a wide range of issues in cancer care for people with mental disorders and offer corresponding solutions for both cancer care professionals and psychiatric care professionals. METHODS We distributed open-ended questionnaires to 754 healthcare professionals in various medical facilities, including designated cancer hospitals, psychiatric hospitals, and other local healthcare/welfare facilities. Participants were asked to describe issues in cancer care for people with mental disorders. RESULTS Of the 754 recruited professionals, 439 (58.2%) responded to the questionnaire. Sixty-one issues were extracted and categorized into 10 categories: patient factors; isolation and lack of support; obstacles to transport; socioeconomic factors; attitudes of psychiatric professionals; medical system of psychiatric hospitals; attitudes of cancer care professionals; medical system of designated cancer hospitals; regional cancer medical systems; and lack of coordination among multidisciplinary healthcare professionals. Forty-eight specific solutions were summarized into 12 goals. CONCLUSIONS The present study widely identified issues causing disparities in cancer care for patients with mental disorders. We found that the issues extended from the patient level to the public-policy level. Our findings suggest the need for a multidisciplinary approach that includes both cancer and psychiatric care professionals to address the gap in cancer care for people with mental disorders.
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Affiliation(s)
- Tsuyoshi Etoh
- Department of Nursing, Shimane University Hospital, Izumo, Japan
| | - Masaki Fujiwara
- Department of Neuropsychiatry, Okayama University Hospital, Okayama, Japan
| | - Yuto Yamada
- Department of Neuropsychiatry, Okayama University Hospital, Okayama, Japan
| | - Riho Wada
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | | | - Shinichiro Inoue
- Department of Neuropsychiatry, Okayama University Hospital, Okayama, Japan
| | | | | | | | | | - Maiko Fujimori
- Division of Health Care Research, Behavioral Sciences and Survivorship Research Group and Division of Cohort Consortium Research, Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Kyoko Kakeda
- Department of Neuropsychiatry, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Taichi Shimazu
- Behavioral Science Division, Center for Public Health Sciences, National Cancer Center, Behavioral Sciences and Survivorship Research Group, Tokyo, Japan
| | - Naoki Nakaya
- Department of Health Sciences, Saitama Prefectural University, Koshigaya, Japan.,Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Masahiro Tabata
- Departments of Allergy and Respiratory Medicine, Okayama University Hospital, Okayama, Japan
| | - Yosuke Uchitomi
- Behavioral Sciences and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.,Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
| | - Norihito Yamada
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Masatoshi Inagaki
- Department of Psychiatry, Faculty of Medicine, Shimane University, Izumo, Japan
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Günther MP, Schulze JB, Jellestad L, Mehnert-Theuerkauf A, von Känel R, Euler S. Mental disorders, length of hospitalization, and psychopharmacy-New approaches to identify barriers to psychological support for patients with cancer. Psychooncology 2021; 30:1773-1781. [PMID: 34089283 DOI: 10.1002/pon.5743] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/04/2021] [Accepted: 06/01/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Despite abundant evidence that emotional distress is frequent in cancer patients and associated with adverse health outcomes, distress screening rates and adequate referrals to psychological support programs among those in need are insufficient in many cancer centers. We therefore aimed to analyze patient- and treatment-related barriers to distress screening and referrals to psychological support as a mandatory component of best-practice cancer care. METHOD In the present explorative study, latent class analysis was used to identify homogeneous subgroups among 4837 patients diagnosed with cancer between 2011 and 2019. RESULTS Four subgroups were identified. Patients with a mental disorder and psychopharmacology were least probable to be screened for distress. Together with patients aged 65 or older and male patients, they were also less likely to receive psychological support. Patients hospitalized for 28 days or longer were most likely to be both screened and to receive psychological support. CONCLUSIONS Clinicians and researchers are recommended not neglect patients with mental disorders and psychopharmacological treatment as well as male and elderly patients when screening for distress and providing access to psychological support.
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Affiliation(s)
- Moritz Philipp Günther
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Jan Ben Schulze
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Lena Jellestad
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Roland von Känel
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sebastian Euler
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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