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Severe mental illness in cancer is associated with disparities in psycho-oncological support


Günther, Moritz Philipp; Schulze, Jan Ben; Kirchebner, Johannes; Jordan, Katja-Daniela; von Känel, Roland; Euler, Sebastian (2022). Severe mental illness in cancer is associated with disparities in psycho-oncological support. Current Problems in Cancer, 46(3):100849.

Abstract

Patients with both cancer and a severe mental illness (SMI) have a higher risk of advanced stage cancer at diagnosis and poorer survival in comparison to individuals with cancer alone. The present study explores if similar disparities exist in terms of psycho-oncological support.

Latent class analysis (LCA) was used to group 10,945 patients with any type of cancer, of which 72 (0.7%) had been diagnosed with a SMI (ICD10-codes F20-F22, F24, F25, F28-F31, F32.3, F33.3), and 1056 (9.6%) with another mental disorder. Subgrouping was based on presence of SMI, other mental illnesses, stage of cancer at its first detection, screening for distress and receipt of information on psycho-oncology, consultation with a psychotherapist and/or psychiatrist, prescription of different psychotropic medication, and use of a patient care attendant.

Five subgroups were identified. Patients with SMI were most likely to suffer from further mental comorbidities, to be prescribed antipsychotics, antidepressants, or mood stabilizers, and be in need of a patient care attendant. In comparison to patients without SMI, the larger one of 2 subgroups of patients with SMI had a low probability to be screened for distress and informed about psycho-oncological support services. A smaller subgroup of patients with SMI was probable to be diagnosed with an advanced stage of cancer. In subgroups without patients with mental disorders, screening for distress and offering psycho-oncological support seemed to be economized unless benzodiazepines or opioids were prescribed.

Contrary to published evidence, distress screening and offering psycho-oncological support is neglected in patients with SMI unless an advanced stage of cancer is being diagnosed.

Abstract

Patients with both cancer and a severe mental illness (SMI) have a higher risk of advanced stage cancer at diagnosis and poorer survival in comparison to individuals with cancer alone. The present study explores if similar disparities exist in terms of psycho-oncological support.

Latent class analysis (LCA) was used to group 10,945 patients with any type of cancer, of which 72 (0.7%) had been diagnosed with a SMI (ICD10-codes F20-F22, F24, F25, F28-F31, F32.3, F33.3), and 1056 (9.6%) with another mental disorder. Subgrouping was based on presence of SMI, other mental illnesses, stage of cancer at its first detection, screening for distress and receipt of information on psycho-oncology, consultation with a psychotherapist and/or psychiatrist, prescription of different psychotropic medication, and use of a patient care attendant.

Five subgroups were identified. Patients with SMI were most likely to suffer from further mental comorbidities, to be prescribed antipsychotics, antidepressants, or mood stabilizers, and be in need of a patient care attendant. In comparison to patients without SMI, the larger one of 2 subgroups of patients with SMI had a low probability to be screened for distress and informed about psycho-oncological support services. A smaller subgroup of patients with SMI was probable to be diagnosed with an advanced stage of cancer. In subgroups without patients with mental disorders, screening for distress and offering psycho-oncological support seemed to be economized unless benzodiazepines or opioids were prescribed.

Contrary to published evidence, distress screening and offering psycho-oncological support is neglected in patients with SMI unless an advanced stage of cancer is being diagnosed.

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Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Psychiatric University Hospital Zurich > Clinic for Psychiatry, Psychotherapy, and Psychosomatics
04 Faculty of Medicine > University Hospital Zurich > Klinik für Konsiliarpsychiatrie und Psychosomatik
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Oncology
Life Sciences > Cancer Research
Uncontrolled Keywords:Cancer Research, Oncology
Language:English
Date:1 June 2022
Deposited On:20 Dec 2022 15:18
Last Modified:29 May 2024 01:40
Publisher:Elsevier
ISSN:0147-0272
OA Status:Hybrid
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1016/j.currproblcancer.2022.100849
PubMed ID:35325803
  • Content: Published Version
  • Licence: Creative Commons: Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)