PSYCHOSOCIAL CARE OF ONCOLOGICAL INPATIENTS - AN EMPIRICAL-STUDY OF PSYCHIATRIC AND PSYCHOSOMATIC CONSULTATION SERVICES

Background: In spire of the high prevalence of mental disorder and the availability of effective treatments, little is known about psychosoc ial carl for oncological inpatients under routine conditions in acute care hospitals. This study examines referrals of cancer patients to ps ychosomatic and psychiatric consultation (CL) services and the type an d extent of psychosocial care they receive. Patients and Methods: An a nalysis was made of the consecutive CL referrals of 167 patients from a total of 11 German general hospitals. These CL referrals were reliab ly documented within the framework of a large-scale collaborative stud y of mental health care delivery in general hospitals. Results: Only 1 67 (6%) of all CL referrals concerned cancer patients. These patients had little Frier contact with psychosocial care, were often referred l ate and mainly for current psychological symptoms (44%) or problems co ping with the illness (26%), According to ICD-10 chapter F, their most frequent mental disorder diagnoses were anxiety or depression as a re action to stress (35%), organic mental disorder (27%), and mood disord er (11%), Their global psychosocial functioning was moderately impaire d (GAF scale 55). CL interventions were short (122 +/- 132 min; mean /- sd), mostly patient focused, and unspecific. Compared to psychosoma tic CL practitioners. psychiatrists spent less time and used more psyc hotropic drugs, Postdischarge specialist psychosocial care was frequen tly recommended (24%). Conclusions: The often late involvement and ver y low utilization level of CL services indicate insufficient integrati on of psychosocial treatment in oncology under conditions of routine c are. The establishment of psychosocial liaison services to promote the cooperation of all professional groups involved in the treatment of o ncological patients is recommended.