Predictors of psychiatric comorbidity in cancer patients at the time of their discharge from the hospital

Julia Roick,Kirsten Papsdorf,Jürgen Meixensberger,Andreas Dietz,Jens-Uwe Stolzenburg,Hubert Wirtz,Anette Kersting,Susanne Singer,Helge Danker,Arne Dietrich

doi:10.1007/s00127-021-02138-1

Abstract

PurposeA cancer diagnosis can have a substantial impact on one’s mental health. The present study investigated the prevalence and predictors of psychiatric comorbidities in cancer patients at the time of their discharge from the hospital.MethodsPsychiatric comorbidities were assessed shortly before hospital discharge and half a year after hospitalization using a structured clinical interview (SCID), based on the diagnostic and statistical manual of mental disorders (DSM-IV). Frequencies at both time points were estimated using percentages and corresponding 95% confidence intervals. Predictors of mental disorders were identified using binary logistic regression models.ResultsAt time of hospital discharge, 39 out of 334 patients (12%) were diagnosed with a psychiatric comorbidity, and 15 (7%) were diagnosed half a year later. Among the diagnoses, adjustment disorders (3%) were most frequent at the time of hospital release, while major depression (3%) was the most frequent 6 months later. Having a mental disorder was associated with unemployment (odds ratio (OR) 3.4, confidence interval (CI) 1.1–10.9, p = 0.04). There was no evidence that school education (OR 2.0, CI 0.4–9.0, p = 0.38), higher education (OR 0.7, CI 0.2–2.4, p = 0.60), income (OR 1.0, CI 1.0–1.0, p = 0.06), tumor stage (OR 1.1, CI 0.4–3.2, p = 0.85), type of disease (OR 0.6, CI 0.2–2.1, p = 0.47), pain (OR 1.0, CI 1.0–1.0, p = 0.15), fatigue (OR 1.0, CI 1.0–1.0, p = 0.77), or physical functioning (OR 1.0, CI 1.0–1.0, p = 0.54) were related to the presence of a psychiatric comorbidity.ConclusionsUnemployment was associated with at least a threefold increased risk of mental disorder, which highlights the need for special attention to be given to this subgroup of cancer patients.

Highlights

Confrontation with a life-threatening illness such as cancer can lead to anxiety, depression, and other mental health problems in many patients [1,2,3]
Due to the fact that mental health problems are negatively associated with treatment adherence [11, 12] and cancer survival [13, 14], special attention should be given to such problems
The present study investigated the prevalence of comorbid psychiatric diagnosis according to SCID shortly before hospital discharge and half a year later in cancer patients

Summary

Introduction

Confrontation with a life-threatening illness such as cancer can lead to anxiety, depression, and other mental health problems in many patients [1,2,3]. Due to the fact that mental health problems are negatively associated with treatment adherence [11, 12] and cancer survival [13, 14], special attention should be given to such problems. They are not always recognized by physicians [15]; psychiatric comorbidities can lead to untreated side effects in clinical practice [16]. It has been shown that psychiatric comorbidity is associated with more frequent treatments and longer hospital stays [17,18,19]

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