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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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Hirayama T, Ikezawa S, Okubo R, Mizuta T, Iwata S, Suzuki T. Mental health care use and related factors in adolescents and young adults with cancer. Support Care Cancer 2023; 31:247. [PMID: 37000309 PMCID: PMC10066100 DOI: 10.1007/s00520-023-07708-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 03/26/2023] [Indexed: 04/01/2023]
Abstract
PURPOSE The actual state of mental health care use and related factors in adolescent and young adult (AYA) patients with cancer is not well understood in Japan. This study aimed to (1) examine the actual state of mental health care use among AYA patients with cancer and (2) describe socio-demographic and related factors associated with mental health care use. METHODS We retrospectively reviewed the medical records of AYA patients with cancer aged 15-39 who first visited the National Cancer Center Hospital in Japan (NCCH) between January 2018 and December 2020. Logistic regression was used to analyze the association between social background characteristics and mental health care use. The association between the patient's course of cancer treatment and mental health care use was analyzed to help identify which patients might benefit from early mental health intervention. RESULTS Among 1,556 patients, 945 AYA patients with cancer were registered. The median age at the time of the study was 33 years (range, 15-39 years). The prevalence of mental health care use was 18.0% (170/945). Age 15-19 years, female gender, urogenital cancer, gynecological cancer, bone or soft tissue cancer, head and neck cancer, and stage II-IV disease were associated with mental health care use. Regarding treatment, palliative treatment, chemotherapy, and hematopoietic stem cell transplantation were associated with mental health care use. CONCLUSION Factors associated with mental health care use were identified. Our findings potentially contribute to psychological support interventions for AYA patients with cancer.
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Affiliation(s)
- Takatoshi Hirayama
- Department of Psycho-Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan.
| | - Satoru Ikezawa
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
- Endowed Institute for Empowering Gifted Minds, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
| | - Ryo Okubo
- Department of psychiatry and neurology, National hospital organization Obihiro hospital, Hokkaido, Japan
| | - Tomoko Mizuta
- Department of Psycho-Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, Japan
| | - Shintaro Iwata
- Department of Musculoskeletal Oncology and Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Tatsuya Suzuki
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
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The influence of socio-demographics and clinical characteristics on coping strategies in cancer patients: a systematic review. Support Care Cancer 2022; 30:8785-8803. [PMID: 35804175 DOI: 10.1007/s00520-022-07267-0] [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: 01/11/2022] [Accepted: 06/27/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Cancer is a frequent illness and a traumatic experience for both patients and their families. This systematic review aims to analyse studies that examine socio-demographic and clinical characteristics that predict the coping strategies in cancer patients. METHODS From January 2000 to March 2021, the database searches were conducted in 7 different databases, using relevant keywords. According to PRISMA Statements, full-text, peer-reviewed articles in English which used socio-demographics as independent variables and coping as dependent variables were included. RESULTS Of 1101 abstracts and titles, 30 full-text papers were included. Overall results showed a great influence of socio-demographic characteristics (such as women, younger, in a relationship, with high educational level, with active work status, and high income) on positive coping strategies adopted by cancer patients. Regarding clinical characteristics, no-metastatic patients who have recently been diagnosed, especially in the early stage of cancer, and who know the characteristics of their illness and treatments, more frequently used adaptive coping strategies. CONCLUSIONS Both socio-demographics and clinical characteristics showed considerable influence on the coping strategies adopted by patients in most of the investigations. These results supported the assessment of basic patients' information (sociodemographic and clinical characteristics) as fundamental to quickly outline an efficient, supportive, and holistic taking-over, before all the essential and in-depth considerations. TRIAL REGISTRATION This systematic review was recorded in PROSPERO with the registration number: CRD42021254776.
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Park CHK, Kim H, Kim Y, Joo YH. Characteristics of Patients Presenting to a Psycho-Oncology Outpatient Clinic. Psychiatry Investig 2021; 18:743-754. [PMID: 34333898 PMCID: PMC8390942 DOI: 10.30773/pi.2021.0093] [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: 03/11/2021] [Accepted: 05/27/2021] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE We aimed to determine the overall profile of patients in a psycho-oncology clinic and the differences in their characteristics according to the cancer site. METHODS The charts of 740 patients aged under 81 years were reviewed. The data from 586 completed questionnaires were subjected to multiple comparison analyses using one-way analysis of variance to examine the demographic and clinical differences according to the cancer site. RESULTS Most (n=532, 71.9%) patients were referred. Most new patients (n=426, 96.6%) received a psychiatric diagnosis; the most common diagnosis was depressive disorder (n=234, 31.6%). Likewise, depressive disorder accounted for the majority of diagnoses in all groups except for the digestive system cancer group in which sleep-wake disorder was the most prevalent. The female genital cancer group showed a higher level of anxiety symptoms than other groups, except for breast and haematolymphoid cancer groups, and psychological distress than all other groups. CONCLUSION There appear to be delays in the referral of cancer patients seeking psychiatric help to a psycho-oncology clinic. Along with tailoring approaches by cancer site, thorough evaluation and appropriate management of sleep-wake and anxiety symptoms are important for digestive system and female genital cancer patients, respectively.
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Affiliation(s)
- C Hyung Keun Park
- Department of Psychiatry, Asan Medical Center, Seoul, Republic of Korea
| | - Harin Kim
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yangsik Kim
- Mental Health Research Institute, National Center for Mental Health, Seoul, Republic of Korea
| | - Yeon Ho Joo
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Anuk D, Özkan M, Kizir A, Özkan S. The characteristics and risk factors for common psychiatric disorders in patients with cancer seeking help for mental health. BMC Psychiatry 2019; 19:269. [PMID: 31481035 PMCID: PMC6724340 DOI: 10.1186/s12888-019-2251-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 08/22/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although the adverse effects of cancer diagnoses and treatments on mental health are known, about less than 10% of patients are estimated to be referred to seek help. The primary purpose of this study was to obtain the baseline information on patients with cancer seeking help for mental health who presented for the first time to the psycho-oncology outpatient clinic, and to identify risk factors that may provide clues healthcare practitioners in recognizing those needing psychological help in oncology practice. METHODS We reviewed the charts of 566 patients with cancer who were referred to the psycho-oncology outpatient clinic over a two-year period. The study includes the socio-demographic data, illness characteristics, psychiatric characteristics, psychiatric diagnoses, and treatment recommendations for these patients. RESULTS The incidence of diagnoses of psychiatric disorders was 97.5%. The distributions of psychiatric diagnoses were as follows: any kind of adjustment disorders, mood disorders, anxiety disorders, organic brain syndrome, personality disorders, delusional disorder, and insomnia. Recurrence of cancer, other chronic medical illnesses, a history of psychiatric disorders, poor social support, and low income comprised the common significant risk factors for adjustment disorders, mood disorders, and anxiety disorders. These risk factors were also seen to be significant in the regression analysis in terms of sex. CONCLUSION This study identifies the distribution of psychiatric disorders, the risk factors for specific psychiatric disorders, and draws attention to the fact that there are serious delays in patients seeking psychiatric help and in the referrals of oncologists for psychological assessment. Identifying risk factors and raising oncologists' awareness toward risk factors could help more patients gain access to mental health care much earlier.
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Affiliation(s)
- Dilek Anuk
- Department of Consultation Liaison Psychiatry, Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Capa, 34390, Istanbul, Turkey.
| | - Mine Özkan
- 0000 0001 2166 6619grid.9601.eDepartment of Consultation Liaison Psychiatry, Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Capa, 34390 Istanbul, Turkey
| | - Ahmet Kizir
- 0000 0001 2166 6619grid.9601.eDepartment of Radiation Oncology, Institute of Oncology, Istanbul University, 34390 Istanbul, Capa Turkey
| | - Sedat Özkan
- 0000 0001 2166 6619grid.9601.eDepartment of Consultation Liaison Psychiatry, Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Capa, 34390 Istanbul, Turkey
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Early detection and successful treatment of Wernicke's encephalopathy in outpatients without the complete classic triad of symptoms who attended a psycho-oncology clinic. Palliat Support Care 2018; 16:633-636. [DOI: 10.1017/s1478951518000032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveWernicke's encephalopathy (WE) is a neuropsychiatric disorder caused by a thiamine deficiency. Although WE has been recognized in cancer patients, it can be overlooked because many patients do not exhibit symptoms that are typical of WE, such as delirium, ataxia, or ocular palsy. Furthermore, outpatients with WE who intermittently present at psycho-oncology clinics have not been described as far as we can ascertain.MethodThis report describes two patients who did not exhibit the complete classic triad of symptoms among a series with cancer and WE, and who attended a psycho-oncology outpatient clinic.ResultCase 1, a 76-year-old woman with pancreatic cancer and liver metastasis, periodically attended a psycho-oncology outpatient clinic. She presented with delirium and ataxia as well as appetite loss that had persisted for 8 weeks. We suspected WE, which was confirmed by low serum thiamine levels and the disappearance of delirium after thiamine administration. Case 2, a 79-year-old man with advanced stomach cancer, was referred to a psycho-oncology outpatient clinic with depression that had persisted for about 1 month. He also had appetite loss that had persisted for several weeks. He became delirious during the first visit to the outpatient clinic. Our initial suspicion of WE was confirmed by low serum thiamine levels and the disappearance of delirium after thiamine administration. The key indicator of a diagnosis of WE in both patients was appetite loss.Significance of resultsThis report emphasizes awareness of WE in the outpatient setting, even when patients do not exhibit the classical triad of WE. Appetite loss might be the key to a diagnosis of WE in the absence of other causes of delirium.
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Yazdanshenas Ghazwin M, Tavakoli SAH, Latifi S, Saberi H, Derakhshanrad N, Yekaninejad MS, Sadeghi M, Emami Razavi SH, Norouzi Javidan A, Ghodsi SM. Psychological defense mechanisms among individuals with SCI with adjustment disorder. J Spinal Cord Med 2017; 40:538-547. [PMID: 27077569 PMCID: PMC5815149 DOI: 10.1080/10790268.2016.1140389] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVES The used psychological defense styles among individuals with spinal cord injury (SCI) with adjustment disorders (AJD) have not yet been described. In the present investigation, the prevalence of AJD among people with SCI has been estimated and the pattern of used defense styles has been identified. DESIGN Cross-sectional investigation. SETTING A tertiary rehabilitation center in Iran. PARTICIPANTS Individuals referred to Brain and Spinal Cord Injury Research Center were invited to participate in a screening interview. AJD was diagnosed based on DSM-V criteria. Those with AJD diagnosis were scheduled for another interview to assess defense mechanisms. OUTCOME MEASURES Demographic and injury-related variables were recorded. Defense mechanisms were assessed by the 40-item version of the Defense-Style Questionnaire (DSQ-40). RESULTS Among 114 participants, 32 (28%) were diagnosed with AJD among whom 23 subjects attended the second interview. Mean age and time since injury were 29.57 ± 9.29 years and 11.70 ± 6.34 months, respectively. The majority of patients were using idealization defense mechanism (91.3%). In the second and third place, passive aggression (87.0%) and somatization (82.6%) defense mechanisms were observed, respectively. Neurotic style was dominantly used (11.52 ± 2.26). Sex, marital status, educational level, cause of the injury and injury level were not related to defense style (P: 0.38, 0.69, 0.88, 0.73, and P: 0.32, respectively). CONCLUSION Prevalence of AJD is estimated to be 28% among individuals with SCI. The most prevalent defense style was neurotic and the dominant used defense mechanism was "idealization." The role of demographic and injury-related variables in determining the used defense mechanisms was insignificant.
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Affiliation(s)
- Manijeh Yazdanshenas Ghazwin
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran,Correspondence to: Manijeh Yazdanshenas Ghazwin, Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Imam Khomeini Complex Hospital, Keshavarz Boulevard, Gharib Street, PO. Box: 6114185, Tehran, Iran.
| | | | - Sahar Latifi
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hooshang Saberi
- Department of Neurosurgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazi Derakhshanrad
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Sadeghi
- Psychiatric and Psychology Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed-Hassan Emami Razavi
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Norouzi Javidan
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed-Mohammad Ghodsi
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
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SAHA R, JAKHAR K. Oligodendroglioma presenting as chronic mania. SHANGHAI ARCHIVES OF PSYCHIATRY 2015; 27:183-5. [PMID: 26300601 PMCID: PMC4526832 DOI: 10.11919/j.issn.1002-0829.215039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 05/29/2015] [Indexed: 11/06/2022]
Abstract
Summary Oligodendrogliomas may present with a variety of psychological symptoms but it only rarely
presents with mania. The patient described in this case report is a 55-year-old man with a three year history
of progressive mania who was initially diagnosed as chronic mania but a subsequent MRI identified a brain
tumor. This report highlights the importance of considering differential organic diagnosis when patients
present with atypical presentations of psychiatric disorders. A brain tumor should be considered and
brain imaging studies conducted for patients with a late age of onset who do not respond to appropriate
medication.
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Affiliation(s)
- Rahul SAHA
- Department of Psychiatry and Deaddiction; PGIMER, Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Kiran JAKHAR
- Department of Psychiatry and Deaddiction; PGIMER, Dr Ram Manohar Lohia Hospital, New Delhi, India
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Suicidal tendency in a sample of adolescent outpatients with adjustment disorder: gender differences. Compr Psychiatry 2014; 55:1342-9. [PMID: 24889338 DOI: 10.1016/j.comppsych.2014.04.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 04/25/2014] [Accepted: 04/28/2014] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Although Adjustment Disorder (AD) is a prevalent diagnosis in adolescent mental health services and linked to suicidal tendency in adolescence, little research exists examining prevalence and gender differences of suicidal symptoms among AD patients using standardized instruments. AIMS The present study aims to assess the presence of suicidal tendency in a clinical sample of Spanish adolescents with AD analyzing gender differences. METHOD Ninety-seven adolescents with AD were recruited at a public mental health center and included in the AD sample; they were administered the Inventario de Riesgo Suicida para Adolescentes (Suicide Risk Inventory for Adolescents-IRIS) and the Millon Adolescent Clinical Inventory (MACI). Ninety-nine community adolescents were recruited and administered the IRIS inventory. The community sample works as a contrast group. RESULTS Girls with AD show higher levels of suicidal symptoms than boys on both the IRIS Suicidal Ideation and Intention scale (t=8.15, p<.001) and the MACI Suicidal Tendency scale (t=6.6, p<.001). Girls with AD scored significantly higher than girls from the community contrast group sample in the IRIS Suicidal Ideation and Intention scale, but boys with AD presented no differences with regard to boys form the community contrast group sample. Compared with normative clinical samples of the MACI, no differences in the Suicidal Tendency scale scores were found between AD and normative girls, but AD boys showed significantly lower mean scores than normative boys. Suicidal symptoms were presented by 27% of girls and 18% of boys, although only 6% of the girls and none of the boys presented clear suicidal tendencies. CONCLUSIONS Considering suicidal tendencies in adolescents with Adjustment Disorder is important-especially in girls, who present high suicidal tendencies in relation both to boys and to community peers and the normative clinical population.
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Maneeton B, Maneeton N, Mahathep P. Prevalence of depression and its correlations: a cross-sectional study in Thai cancer patients. Asian Pac J Cancer Prev 2013; 13:2039-43. [PMID: 22901168 DOI: 10.7314/apjcp.2012.13.5.2039] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Depression is common in cancer patients. However, only limited evidence is available for Asian populations. The authors therefore examine the prevalence of depression in Thai patients with cancer. In addition, associated factors were determined. METHODS This cross-sectional study was conducted in cancer patients admitted to a university hospital during December 2006--December 2007. The Patient Health Questionnaire (PHQ-9) was used to assess all cancer patients. Suicidal risk was assessed by using the Mini-International Neuropsychiatric Interview (MINI) in the module of suicidal risk assessment. RESULTS Of 108 cancer patients, 29.6% were diagnosed with a depressive disorder (mild, 14.8%; moderate, 5.6%; severe, 9.3%). However, only 25.0% of these were recognized as being depressed by the primary physician. According to the MINI., 28.1% of these depressed cancer patients had a moderate to severe level of suicidal risk. In addition, the findings suggest that increased risk of depression is significantly associated with increased pain score, lower number of cancer treatments (<2 methods), increased educational duration (>13 years), increased age (>50 years old) and being female. CONCLUSIONS The prevalence of depression is high in Thai cancer patients. However, depressive disorder in those patients is frequently undiagnosed. It is associated with several factors including pain, a number of cancer treatments, education duration, age and sex. To improve quality of life, increase compliance with treatments and prevent of suicide, screening for depressive disorders in this patient group is strongly recommended.
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Affiliation(s)
- Benchalak Maneeton
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Matsunaga M, Onishi H, Ishida M, Miwa K, Araki K, Kaneta T, Sunakawa Y, Nakayama H, Shimada K, Noguchi T, Narabayashi M, Sasaki Y. Hypomanic episode during recurrent gastric cancer treatment: report of a rare case and literature review. Jpn J Clin Oncol 2012; 42:961-4. [PMID: 22872746 DOI: 10.1093/jjco/hys127] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
S-1 plus cisplatin is the standard chemotherapy for recurrent gastric cancer. While depression and delirium are frequent in cancer patients, hypomania during chemotherapy is rare. We describe a rare case of hypomania during S-1 plus cisplatin treatment for recurrent gastric cancer. A 66-year-old woman, with no previous psychiatric disorder, received S-1 plus cisplatin for recurrent gastric cancer. She showed peculiar behavior. Physical examination, urine, blood and imaging findings were normal. There was no gastric cancer progression. During psychiatric consultation, she behaved inappropriately. However, she behaved normally while performing daily activities. She manifested a persistently elevated, expansive or irritable mood, clearly different from her usual non-depressed state, meeting hypomania diagnostic criteria. Her condition did not require chemotherapy discontinuation or additional medication. During the second and subsequent S-1 plus cisplatin cycles, symptoms were stable. Cancer patients often have adjustment disorders, depression and delirium, but rarely hypomania. Our patient showed no significant changes in blood biochemistry and brain and whole body imaging. While S-1 plus cisplatin-induced hypomania cannot be excluded, hypomanic symptoms did not improve during the chemotherapy rest period, nor was there deterioration during subsequent cycles, suggesting drug-induced mania to be unlikely. Possible onset mechanisms include manic defense phenomena, common with stressful life events. There are no reports of recurrent gastric cancer patients experiencing hypomania during S-1 or S-1 plus cisplatin therapy, i.e. our patient represents a rare course. Clinicians should recognize psychosis or mood disorders during gastric cancer treatment. Further accumulation of such rare cases might elucidate pathological mechanisms underlying hypomania in cancer patients.
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Affiliation(s)
- Mototsugu Matsunaga
- Department of Medical Oncology, International Medical Center-Comprehensive Cancer Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama, Japan.
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