Clinical and demographic profile of cancer patients in a consultation-liaison psychiatric service

Authors

  • Vanessa de Albuquerque Citero Universidade Federal de São Paulo – Escola Paulista de Medicina, with the cooperation of the Treatment and Research Center, Hospital do Câncer AC Camargo
  • Luiz Antonio Nogueira-Martins Universidade Federal de São Paulo — Escola Paulista de Medicina, with the cooperation of the Treatment and Research Center, Hospital do Câncer AC Camargo
  • Maria Teresa Lourenço Universidade Federal de São Paulo — Escola Paulista de Medicina, with the cooperation of the Treatment and Research Center, Hospital do Câncer AC Camargo
  • Sergio Baxter Andreoli Universidade Federal de São Paulo — Escola Paulista de Medicina, with the cooperation of the Treatment and Research Center, Hospital do Câncer AC Camargo

Keywords:

Referral and consultation, Consultations, Psychiatry, Mental Health Services, Evoluation Studies, Oncology Service, Cancer care Facilities, Cancer, Epidemiology

Abstract

CONTEXT: An almost 50% prevalence of psychiatric disorders among cancer patients has prompted a series of studies on consultation-liaison psychiatry. Nonetheless, there are few reports on the epidemiological factors involving comorbidity between cancer and psychiatric disorders. OBJECTIVE: To evaluate the epidemiological profile of cancer inpatients referred to the consultationliaison psychiatric service in an oncology hospital during its first year of activity. TYPE OF STUDY: Descriptive study. SETTING: Tertiary-care teaching hospital. PARTICIPANTS: 319 patients referred 412 times to the consultation-liaison psychiatry service. PROCEDURES: From August 97 to July 98, an appraisal was made of data on all admissions registered at the Hospital do Câncer, and also all referrals registered at the consultation-liaison psychiatry service. MAIN MEASUREMENTS: The demographics and patients’ clinical data, the type and flow of the request, and the evaluation conducted by the service were analyzed and comparisons with the hospital data were made. The distribution of the number of referrals was used to construct a profile of patients who had repeatedly used the service. RESULTS: Psychiatric diagnoses were found in 59% of the cases. Forty-three percent of these required medication, 18.3% needed psychotherapy, 22.1% family intervention and 20.5% guidance from the staff. Over 22.8% of the consultations were reevaluations, mainly involving younger male patients with worst prognoses. These patients required lengthier and more elaborate intervention, and had higher prevalence of depressive and behavioral disorders. CONCLUSION: A younger and mainly male population of non-surgical oncological cases was referred to the consultation-liaison psychiatric service during its first year of activity. The psychiatric disorder prevalence was higher than expected, and consisted predominantly of mood disorders. We detected a priority group, namely the reevaluated patients, who deserved special attention throughout the psychiatric interventions.

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Author Biographies

Vanessa de Albuquerque Citero, Universidade Federal de São Paulo – Escola Paulista de Medicina, with the cooperation of the Treatment and Research Center, Hospital do Câncer AC Camargo

MD, MSc. Coordinator of the Psychosocial Service of the Department of Psychiatry, Universidade Federal de São Paulo – Escola Paulista de Medicina, São Paulo, Brazil.

Luiz Antonio Nogueira-Martins, Universidade Federal de São Paulo — Escola Paulista de Medicina, with the cooperation of the Treatment and Research Center, Hospital do Câncer AC Camargo

MD, PhD. Associate professor of the Department of Psychiatry, Universidade Federal de São Paulo – Escola Paulista de Medicina, São Paulo, Brazil.

Maria Teresa Lourenço, Universidade Federal de São Paulo — Escola Paulista de Medicina, with the cooperation of the Treatment and Research Center, Hospital do Câncer AC Camargo

MD, PhD. Director of the Department of Psychiatry, Treatment and Research Center, Hospital do Câncer AC - Camargo, São Paulo, Brazil.

Sergio Baxter Andreoli, Universidade Federal de São Paulo — Escola Paulista de Medicina, with the cooperation of the Treatment and Research Center, Hospital do Câncer AC Camargo

MD, PhD. Coordinator of the Applied Statistics and Methodology Center and Affiliated Professor in the Department of Psychiatry, Universidade Federal de São Paulo – Escola Paulista de Medicina, São Paulo, Brazil.

References

Hall R, Rundell J, Hirsch TW. Economic issues in consulta- tion-liaison psychiatry. In: Rundell J, Wise MG, editors. Text- book of consultation-liaison psychiatry. Washington: Ameri- can Psychiatric Press; 1996.p.24-37.

Strain JJ, Hammer JS, Fulop G. APM task force on psy- chosocial interventions in the general hospital inpatient set- ting. A review of cost-offset studies. Psychosomatics 1994;35(3):253-62.

Derogatis LR, Morrow GR, Fetting J, et al. The prevalence of psychiatric disorders among cancer patients. JAMA 1983;249(6):751-7.

Cullivan R, Crown J, Walsh N. The use of psychotropic medi- cation in patients referred to a psycho-oncology service. Psychooncology 1998;7(4):301-6.

Massie M, Popkin MK. Depressive disorders. In: Holland JC, editor. Psycho-oncology. New York: Oxford University Press; 1998.p.518-40.

Razavi D, Delvaux N, Farvacques C, Robaye E. Screening for adjustment disorders and major depressive disorders in cancer in-patients. Br J Psychiatry 1990;156:79-83.

Breitbart W, Cohen KR. Delirium. In: Holland JC, editor. Psycho- oncology. New York: Oxford University Press; 1998.p.564-75.

Kunkel EJ, Woods CM, Rodgers C, Myers RE. Consultations for ‘maladaptive denial of illness’ in patients with cancer: psy- chiatric disorders that result in noncompliance. Psychooncology 1997;6(2):139-49.

Citero VA. Descriçao e avaliaçao da implantaçao do serviço de interconsulta psiquiátrica no Centro de Tratamento e Pesquisa Hospital do Câncer A. C. Camargo [tesis]. São Paulo: Universidade Federal de São Paulo - Escola Paulista de Medicina; 1999.

Wise M, Rundell JR. Concise guide to consultation psychiatry. 2nd edition. Washington: American Psychiatric Press; 1994.

Botega NJ. Consultation-liaison psychiatry in Brazil. Psychiatric residency training. Gen Hosp Psychiatry 1992;14(3):186-91.

Citero VA, Andreoli PBA, Nogueira-Martins LA, et al. Por que é tão difícil avaliar a efetividade da interconsulta psiquiátrica?. Rev Bras Psiquiatr 2002;24(2):100.

Andreoli PBA, Mari JJ. Assessment of a consultation-liaison psychiatry and psychology health care program. Rev. Saúde Pública 2002;36(2):222-9.

Rait DS, Jacobsen PB, Lederberg MS, Holland JC. Character- istics of psychiatric consultations in a pediatric cancer center. Am J Psychiatry 1988;145(3):363-4.

Desai MM, Bruce ML, Kasl SV. The effects of major depres- sion and phobia on stage at diagnosis of breast cancer. Int J Psychiatry Med 1999;29(1):29-45.

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Published

2003-05-05

How to Cite

1.
Citero V de A, Nogueira-Martins LA, Lourenço MT, Andreoli SB. Clinical and demographic profile of cancer patients in a consultation-liaison psychiatric service. Sao Paulo Med J [Internet]. 2003 May 5 [cited 2025 Oct. 16];121(3):111-6. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/2604

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Original Article