Citero Vanessa de Albuquerque, Nogueira-Martins Luiz Antonio, Lourenço Maria Teresa, Andreoli Sergio Baxter
Department of Psychiatry, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.
Sao Paulo Med J. 2003 May 5;121(3):111-6. doi: 10.1590/s1516-31802003000300005. Epub 2003 Aug 8.
An almost 50% prevalence of psychiatric disorders among cancer patients has prompted a series of studies on consultation-liaison psychiatry. Nonetheless, there are few reports on the epidemiological factors involving comorbidity between cancer and psychiatric disorders.
To evaluate the epidemiological profile of cancer inpatients referred to the consultation-liaison psychiatric service in an oncology hospital during its first year of activity.
Descriptive study.
Tertiary-care teaching hospital.
319 patients referred 412 times to the consultation-liaison psychiatry service.
From August 97 to July 98, an appraisal was made of data on all admissions registered at the Hospital do C ncer, and also all referrals registered at the consultation-liaison psychiatry service.
The demographics and patients' clinical data, the type and flow of the request, and the evaluation conducted by the service were analyzed and comparisons with the hospital data were made. The distribution of the number of referrals was used to construct a profile of patients who had repeatedly used the service.
Psychiatric diagnoses were found in 59% of the cases. Forty-three percent of these required medication, 18.3% needed psychotherapy, 22.1% family intervention and 20.5% guidance from the staff. Over 22.8% of the consultations were reevaluations, mainly involving younger male patients with worst prognoses. These patients required lengthier and more elaborate intervention, and had higher prevalence of depressive and behavioral disorders.
A younger and mainly male population of non-surgical oncological cases was referred to the consultation-liaison psychiatric service during its first year of activity. The psychiatric disorder prevalence was higher than expected, and consisted predominantly of mood disorders. We detected a priority group, namely the reevaluated patients, who deserved special attention throughout the psychiatric interventions.
癌症患者中精神障碍的患病率近50%，这促使了一系列关于会诊-联络精神病学的研究。尽管如此，关于癌症与精神障碍共病的流行病学因素的报道却很少。
评估一家肿瘤医院会诊-联络精神科服务开展第一年中，转诊至该科室的癌症住院患者的流行病学特征。
描述性研究。
三级护理教学医院。
319名患者共412次转诊至会诊-联络精神科服务。
从1997年8月至1998年7月，对癌症医院登记的所有入院数据以及会诊-联络精神科服务登记的所有转诊数据进行评估。
分析人口统计学和患者临床数据、请求的类型和流程以及该科室进行的评估，并与医院数据进行比较。使用转诊次数的分布来构建反复使用该服务的患者概况。
59%的病例发现有精神科诊断。其中43%需要药物治疗，18.3%需要心理治疗，22.1%需要家庭干预，20.5%需要工作人员指导。超过22.8%的会诊是重新评估，主要涉及预后较差的年轻男性患者。这些患者需要更长期、更精细的干预，且抑郁和行为障碍的患病率更高。
在会诊-联络精神科服务开展的第一年，转诊至该科室的主要是非手术肿瘤病例的年轻男性人群。精神障碍患病率高于预期，主要为情绪障碍。我们发现了一个优先群体，即重新评估的患者，在整个精神科干预过程中值得特别关注。
