Prevalence and Psychiatric Referrals of Mental Disorders in Hospitalized Cancer Patients

Abstract

Background: Cancer has become the leading cause of death in many countries, and its co-morbid psychologic problems present a challenge to medical professionals. In Taiwan, little research has been conducted on these psychologic problems. Objectives: To examine the prevalence of mental disorders and the frequency of psychiatric referral in hospitalized cancer patients. Methods: The present study was a cross-sectional epidemiologic survey of psychiatric comorbidity in 759 medical inpatients. Psychiatrists conducted in-depth interviews to make a psychiatric diagnosis, and standardized self-report scales were used to assess the subjects’ psychologic distress (Brief Symptom Rating Scale, BSRS-50), personality traits (Maudsley Personality lnventory, MPI), and family function (Family APGAR lndex). We compared 142 subjects with cancer to 617 subjects who had other medical diagnoses. Results: Off the cancer patients, 23.9% had a DSM III-R defined psychiatric diagnosis, which included adjustment disorders (53%), major depression (14.7%), and organic mental disorders (9%). Approximately 80% of those subjects with a psychiatric diagnosis suffered from depression, anxiety, or both. The prevalence of psychiatric disorders and the severity of the psychologic distress in the cancer patients were not statistically different than those in the non-cancer patients. However, the psychiatric referral rate of the cancer patients (12.7%) was significantly higher than the rate of the non-cancer patients (5%). The referral rate was not significantly related to the severity of psychopathology. The cancer patients with a positive psychiatric diagnosis scored significantly higher in neuroticism and significantly lower in extroversion on the MPI. Conclusion: The psychopathology of the cancer inpatients was similar to that of the non-cancer inpatients; however, the rate of psychiatric referral in the cancer patients was significantly higher. Addressing the psychologic needs of the cancer patients may have been more difficult for the non-psychiatric physicians; thus, the rate of referral was higher for these patients.