Pattern of referral to a consultation-liaison psychiatry service in an Egyptian cancer center

Abstract

Aim/Objective/Background Integration of consultation-liaison(C-L) psychiatry services in palliative care units in oncology departments is very limited in Egypt. A new dedicated C-L psychiatry service was recently established within the premises of the palliative care clinic in Kasr al Ainy Center for Clinical Oncology and Nuclear Medicine (NEMROCK), Cairo, Egypt. The aim of this study was to examine the characteristics, diagnoses and follow up of patients referred to this new service in a year period. Methods The clinical and psychiatric characteristics of all consecutive oncology patients (n=44) referred to this new C-L psychiatric service in a year period were examined. Psychiatric diagnosis was made according to the Diagnostic and Statistical Manual of Psychiatric Disorders, 5th edition (DSM 5). Results A total number of 44 patients (12 males and 32 females) were referred to the C-L clinic during the study period. Half of the patients had breast cancer.The other half was a diverse group involving different sites. In the advanced stage of cancer, males were significantly more represented than the females. As regards psychiatric diagnosis, the most common category was adjustment disorder (22 patients) followed by major depression (11 patients). Six of the patients had non-psychiatric distress, two had a primary psychotic disorder, two had substance related disorder and one had a major cognitive disorder. Causes of suffering in the non-psychiatric distressed group included lack of adequate medical information, physical concerns, existential concerns and family concerns. Most patients received psychotropic medication. Conclusions The scope and severity of psychiatric morbidity and distress detected in the referred oncology patients reflects the need to integrate C-L psychiatric services within psycho-oncological and palliative care clinics.