OP23 * AN AUDIT TO ASSESS PSYCHIATRIC CONDITIONS THAT MANIFEST IN PATIENTS WITH HIGH-GRADE BRAIN TUMOURS DURING TREATMENT

Abstract

INTRODUCTION: We recorded over a 9 month period the number of referrals made for specialist advice on how to treat a patient's psychiatric condition from those attending our neuro-oncology clinics. The patient's characteristics were reviewed to understand the causes, produce local referral guidelines, and identify at risk patients at the earliest opportunity. METHOD: We prospectively gathered names of patients referred as outpatients to our Psychological Medicine Department between 1st September 2011 and 31st May 2012. The notes were examined for patient characteristics, tumour biology, current treatment, psychiatric presentation, past psychiatric history, concurrent seizure medication, and psychiatric treatment recommended. RESULTS: During the monitored time we identified 74 patients, 11 of which had a past or current psychiatric history, 8 of which were referred to psychological medicine for specialist advice. Of the 3 not referred, 1 had mild dementia, and the remaining 2 had issues with alcoholism and were managed medically. Only 1 patient was referred having no previous psychiatric history. Most patients had Grade 4 tumours and were having chemo-radiotherapy, but some had chemotherapy only or surgery. Current psychiatric conditions expressed were similar to the patient's past psychiatric condition. Steroid-induced psychosis was not uncommon, and 3 patients benefited from the use of anti-psychotic therapy, or change of steroid. CONCLUSION: The response to diagnosis and treatment appeared to trigger most referrals, however, all the patients completed their treatment safely, and without any interruptions. We are introducing a screening tool used pre-treatment to identify at risk patients, and refer for advice early.