PSYCHIATRIC MORBIDITY IN TERMINALLY ILL CANCER-PATIENTS - A PROSPECTIVE-STUDY

BACKGROUND, In the study by Derogatis et al., which included patients with all stages of cancer, 47% of the patients met the DSM-III criteri a for a psychiatric disorder, with adjustment disorders being the most common. Although the cancer stage is one factor that influences the n ature and incidence of psychiatric disorders, no study has demonstrate d the extensive range of psychiatric disorders in terminally iu cancer patients. METHODS. Ninety-three terminally ill cancer patients were s ystematically assessed using the Mini-Mental State Examination (MMSE) and Structured Clinical Interview for DSM-III-R (SCID) within 1 week o f admission. RESULTS, Of this sample population, 53.7% met the DSM-III -R criteria for a psychiatric disorder and 42% had a cognitive impairm ent. Delirium was observed in 26 patients (28%), dementia in 10 (10.7% ), adjustment disorders in 7 (7.5%), amnestic disorder and major depre ssion in 3 (3.2%), and a generalized anxiety disorder in 1(1.1%). CONC LUSIONS. This preliminary investigation of the prevalence of psychiatr ic disorders in terminally ill cancer patients showed that more than h alf of the patients met the criteria for a DSM-III-R psychiatric disor der; delirium was the most common type of psychiatric disturbance. Fur ther prospective trials are critically important to establishing treat ment modalities that promote the psychiatric wellbeing of patients wit h terminal illnesses. (C) 1996 American Cancer Society.