PSYCHIATRIC MORBIDITY AMONG CANCER-PATIENTS AND ITS RELATIONSHIP WITHAWARENESS OF ILLNESS AND EXPECTATIONS ABOUT TREATMENT OUTCOME

Sixty consecutive patients admitted to an oncology unit in a general h ospital were systematically assessed to determine the prevalence of ps ychiatric disorders. Patients' awareness of the diagnosis of cancer an d their perception of treatment intention and outcome were assessed in dependently by another investigator who was blind to the psychiatric d iagnosis. Forty percent of the sample had a diagnosis of psychiatric d isorder, based on the Diagnostic and Statistical Manual for Mental Dis orders (3rd edition, revised). Adjustment disorders comprised most of the psychiatric diagnoses. Major depression was seen in 8 (13%) patien ts. One third of the patients were estimated to be unaware of the diag nosis of cancer, and 82% of patients perceived the treatment given as curative. Psychiatric morbity was significantly less common in patient s who did not know they had cancer, and in those who considered treatm ent as curative. The prevalence of depressive disorders in our sample was higher than in medical inpatients. It is concluded that psychiatri c disorders, especially affective disorders, are common among cancer p atients. Awareness of nature of the illness and expected outcome can a ffect the prevalence of psychiatric morbidity. Further studies investi gating the relationship between psychiatric morbidity and duration of illness, type and stage of cancer, disabilities and coping strategies are warrented.