Challenges in Treating Cancer Patients With Unstable Psychiatric Disorder

PURPOSE Clinical reports suggest that many breast cancer patients experience persistent fatigue as a long-term side effect of adjuvant chemotherapy treatment. To investigate this issue further, we examined the characteristics and correlates of fatigue in women who had completed adjuvant chemotherapy for breast cancer and in a comparison group of women with no history of cancer. PATIENTS AND METHODS Participants were 61 women with breast cancer who had completed chemotherapy an average of 471 days previously and 59 women with no history of cancer. All participants completed standardized self-report measures of fatigue, sleep quality, menopausal symptoms, and coping and were administered a structured clinical interview to identify current and past psychiatric disorder. RESULTS Compared with women with no history of cancer, former adjuvant chemotherapy patients reported more severe fatigue (P < .01) and worse quality of life because of fatigue (P < .05). More severe fatigue among patients was significantly (P < .05) related to poorer sleep quality, more menopausal symptoms, greater use of catastrophizing as a coping strategy, and current presence of a psychiatric disorder. CONCLUSION These findings support the view that many breast cancer patients experienced heightened fatigue after completion of adjuvant chemotherapy treatment. Results yield a profile of women who are at increased risk for heightened fatigue after chemotherapy and suggest ways to intervene clinically to prevent or reduce fatigue in this patient population.

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Adjustment Disorders in Cancer

Psycho-Oncology ◽

10.1093/med/9780190097653.003.0041 ◽

2021 ◽

pp. 313-319

Author(s):

Froukje de Vries ◽

Sarah Hales ◽

Gary Rodin ◽

Madeline Li

Keyword(s):

Psychiatric Disorder ◽

Cancer Patients ◽

Diagnostic Criteria ◽

Adjustment Disorder ◽

Evidence Base ◽

Adjustment Disorders ◽

Related Disorder ◽

Dsm 5 ◽

And Behaviors

Adjustment disorder (AD) refers to a condition in which an individual reacts to an identifiable stressor with disproportionate symptoms and behaviors. It is now considered as a stress-related disorder in both the DSM-5 and ICD-11 and is the most commonly diagnosed psychiatric disorder in cancer patients. Nevertheless, this diagnosis remains problematic in terms of its conceptualization and evidence base. The specificity of the diagnostic criteria has been questioned and concern has been expressed that it medicalizes distress and increases the likelihood of unnecessary psychopharmacological interventions. However, evidence suggests that categorizing distress as AD may actually lead to appropriate interventions aimed at prevention or treatment. This chapter focuses on the validity and utility of the concept of and diagnostic criteria for AD and reviews the available evidence base regarding treatment of this disorder in cancer patients.

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Exploring Fear of Cancer Recurrence in a Sample of Heterogeneous Distressed Cancer Patients with and Without a Psychiatric Disorder

Journal of Clinical Psychology in Medical Settings ◽

10.1007/s10880-021-09776-2 ◽

2021 ◽

Author(s):

Else M. Bisseling ◽

Félix R. Compen ◽

Melanie P. J. Schellekens ◽

Belinda Thewes ◽

Anne E. M. Speckens ◽

...

Keyword(s):

Psychiatric Disorder ◽

Cancer Patients ◽

Short Form ◽

Psychiatric Morbidity ◽

Specific Treatment ◽

Cancer Recurrence ◽

Fear Of Cancer Recurrence ◽

Axis I ◽

Dsm Iv ◽

Fear Of Cancer

AbstractFear of Cancer Recurrence (FCR) is a concern among cancer patients. Recent insights suggest that FCR should be viewed as a distinct syndrome. However, few studies have explored its overlap with psychiatric morbidity. We examined this overlap in a sample of distressed cancer patients. Self-referred patients (n = 245) were assessed with the Structured Clinical Interview for DSM-IV-TR Axis-I disorders and the Fear of Cancer Recurrence Inventory-Short Form. Proportions of patients with and without a psychiatric disorder meeting validated cut-offs for screening and clinically relevant FCR were compared. The prevalence of psychiatric disorders was 36%. Clinically relevant FCR was found in 198 patients (81%). Patients with a current psychiatric disorder reported clinically relevant FCR more frequently (89%) compared to those with no disorder (77%). Of patients reporting clinically relevant FCR, the majority (61%) did not additionally meet the criteria for a psychiatric disorder. These findings suggest that there should be particular attention for patients with elevated levels of FCR, warranting FCR-specific treatment.Trial registry number Clinicaltrials.gov NCT02138513

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Exploring associations between psychiatric disorder, psychological distress, and health care utilization in cancer patients

Psycho-Oncology ◽

10.1002/pon.4591 ◽

2018 ◽

Vol 27 (3) ◽

pp. 871-878 ◽

Cited By ~ 9

Author(s):

F.R. Compen ◽

E.M.M. Adang ◽

E.M. Bisseling ◽

M.L. Van der Lee ◽

A.E.M. Speckens

Keyword(s):

Health Care ◽

Psychological Distress ◽

Psychiatric Disorder ◽

Health Care Utilization ◽

Cancer Patients ◽

Care Utilization

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The prevalence of psychiatric disorder and the wish to hasten death among terminally ill cancer patients

Palliative & Supportive Care ◽

10.1017/s1478951504040222 ◽

2004 ◽

Vol 2 (2) ◽

pp. 163-169 ◽

Cited By ~ 18

Author(s):

BRIAN J. KELLY ◽

DAN PELUSI ◽

PAUL C. BURNETT ◽

FRANCIS T. VARGHESE

Keyword(s):

Palliative Care ◽

Psychiatric Disorder ◽

Cancer Patients ◽

Depressive Episode ◽

Major Depressive Episode ◽

Terminally Ill ◽

Clinical Interview ◽

Major Depressive ◽

Terminally Ill Cancer Patients ◽

Wish To Hasten Death

Objective: This study assessed the prevalence of psychiatric disorder among a group of terminally ill cancer patients with or without a wish to hasten death (WTHD).Methods: Consecutive patient referrals to a hospice inpatient unit, home palliative care service, and hospital palliative care-consulting service were recruited. A group of these patients (n = 56) consented to participate in a structured clinical interview (SCID) to identify the presence of psychiatric diagnoses. Patients were categorised into those with or without a wish to hasten death.Results: Current major depressive episode and adjustment disorder were the most prevalent disorders in this group of patients. Patients with a high WTHD were significantly more likely to have a current major depressive episode compared to patients with no WTHD. Patients with a high WTHD were also significantly more likely to have a past major depressive episode compared to patients with no WTHD.Significance of results: These results support the view that terminally ill patients with a high WTHD are significantly more likely to be suffering from a depressive disorder as assessed by a structured clinical interview. This has important clinical implications for those caring for dying patients who may make a request to hasten death.

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A PROSPECTIVE STUDY TO ASSESS THE PSYCHIATRIC DISORDER AS CO-MORBIDITY IN CANCER PATIENTS

10.36106/ijar/9205199 ◽

2021 ◽

pp. 72-74

Author(s):

D. Kirupakarakrishnan ◽

N.S. Subbulakshmi

Keyword(s):

Psychiatric Disorder ◽

Cancer Patients ◽

Tertiary Care ◽

Psychiatric Morbidity ◽

Positive Family History ◽

Adjustment Disorder ◽

Care Hospital ◽

Middle Income ◽

Co Morbidity ◽

High Prevalence

Cancer is the one of the leading cause of death, worldwide accounting for 7.6 million deaths that are around 13% of all deaths in 2008, and about 70% of all Cancer deaths occurred in low and middle income countries. Study was planned to assess the Psychiatric disorder as co-morbidity in a group of cancer patients, attending a tertiary care hospital for the treatment .Consecutive Sample of 100 patients was selected for the study, those who attended the clinic in the Department of Radiotherapy, Surgery, and Medical ward for the treatment of cancer, Thanjavur Medical College.we found Psychiatric co-morbidity is highly prevalent in patients with cancer patients. Adjustment disorder and depression are the most common Psychiatric co-morbidity associated with Cancer patients.There is signicantly high prevalence of psychiatric co-morbidity among the female cancer patients.There is high prevalence of psychiatric morbidity among the patients with the positive family history of psychiatric illness. No difference with respect to age, Socioeconomic class is seen in terms of co-morbid Psychiatric disorders.

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