Rates of psychiatric illness in patients with cancer: An analysis of a psycho-oncology service

Abstract

e20731 Background: The diagnosis of cancer represents a major physical and psychological challenge for patients and their families. Psycho-oncology services are limited throughout the country. We assess the service profile of patients assessed between 1/2003 and 6/2008 to determine how the needs of patients have changed. Methods: Case notes from all patients referred by medical oncologists, clinical nurse specialists and/or social workers to the psycho-oncology service were reviewed for the period 7/07 to 6/08. Demographic details, cancer diagnosis and stage, time since diagnosis, psychiatric diagnosis (past/current), and need for psychiatric intervention were collected. This data was compared to a similar review performed from 1/03 to 12/03. Results: 106 patients were psychiatrically assessed during the period 07/08 compared with 63 from 2003, representing a 68% increase in activity. All major cancers were represented. There was a 30% increase in patients assessed with lung cancer (14% in 07/08 vs. 11% in 2003). More patients were referred with localised disease in 07/08 than in 2003 (37.5% vs .19%, p=0.012).Patients with a past history of psychiatric disorder were more likely to be referred in 07/08 compared to 2003 (54% vs. 32% p=0.005). There was a significant decrease in the numbers diagnosed with depression in 07/08 (29% vs. 51%, p= 0.004) with a corresponding increase in the diagnosis of adjustment disorder (26% vs. 6%). Conclusions: Psycho-oncology services remain an important component of care for patients with cancer. The increased rate of referrals may reflect an increased awareness amongst oncology staff of psychological distress in this vulnerable population. No significant financial relationships to disclose.