Psychiatric disorders and associated factors in cancer: results of an interview study with patients in inpatient, rehabilitation and outpatient treatment

An association between mental disorders, especially affective and anxiety d isorders, and cancer has been reported in many studies. The present study i nvestigated current (4-weeks-, 12-months-, and lifetime-prevalence rates of comorbid mental disorders in cancer patients. Through a cross-sectional de sign, 517 patients (75% female patients) from two acute inpatient care clin ics, two rehabilitation clinics and nine specialised practices for oncology were examined with standardised scales for psychological burden and qualit y of life. Somatic parameters were assessed through standardised medical re cords. In the second-stage-examination, a sample of 200 patients was interv iewed with standardised clinical interview (CIDI) in order to obtain DSM-IV diagnoses of mental disorders. Differences in the type of mental disorders were examined for gender, treatment setting, severity of cancer and physic al impairment. Prevalence rates of mental disorders were 23.5% for the 4-we eks, 40% for the 12-months, and 56.5% for the lifetime periods. The current and 12-months rates of affective and anxiety disorders were approximately 25-33% higher than prevalence rates found in recent epidemiological studies of the general population. These higher rates were, however, mainly due to the preponderance of female patients with a higher risk for mental disorde rs compared with males. The most prevalent current disorders were affective (9.5%), and anxiety disorders (13%). Female gender was associated with an approximately 2-fold risk of mental disorders during the patient's lifespan . Current diagnosis of affective disorders in women was highly related to t he cancer. Physical impairment was also associated with the frequency of cu rrent psychiatric disorders, especially affective and anxiety disorders. Th e frequency of mental disorders in cancer patients does not differ from res ults of recent international epidemiological studies of the normal populati on. The slightly higher rates of anxiety disorders are mainly due to phobia s (simple, social and agoraphobia) without urgent need for treatment. A rel atively large portion of patients, however, fulfil the criteria of minor de pressive disorder which deserves clinical attention. (C) 2001 Elsevier Scie nce Ltd. All rights reserved.