Department of Educational & Counselling Psychology and Department of Oncology, McGill University Montreal, QC, Canada.
Int J Dermatol. 2012 Sep;51(9):1060-7. doi: 10.1111/j.1365-4632.2011.05228.x.
Individuals diagnosed with malignant melanoma face significant practical and psychological challenges, including existential fears and pain and discomfort associated with treatment. To enhance psychological adjustment, patients receive psychosomatic-psychotherapeutic consultation-liaison services (CLS) within the general medical hospital. However, little is known about the use of these services in routine clinical care.
This study includes all patients referred to the CLS of a large German tertiary care hospital between 2005 and 2008 (n=3658). Data were recorded using the CL-BaDo form - a multicenter documentation form for the assessment of clinical characteristics of patients and CLS delivery. Descriptive and inferential statistics were employed to compare patients with melanomas and patients with other dermatological diseases.
Dermatologists requested CLS more often for other dermatology patients than for patients with melanoma. These two groups also differed in the reasons for referral: patients with melanoma were referred more often for acute coping issues; other dermatology patients were referred more often for unexplained physical symptoms. Additionally, the latter group was diagnosed with more and different mental and behavioral disorders. Patients with melanomas received more psychotherapeutic interventions while admitted to hospital but fewer recommendations for further psychosocial treatment after their hospital stay.
These findings highlight the need for professional psychosocial support in individuals diagnosed with melanoma - especially when first diagnosed or experiencing a recurrence. Dermatologists play a crucial role in identifying their patients' needs and in navigating them toward available support services.
被诊断患有恶性黑色素瘤的个体面临着重大的实际和心理挑战，包括存在恐惧以及与治疗相关的疼痛和不适。为了增强心理适应能力，患者在综合医院接受身心-心理治疗联络服务（CLS）。然而，对于这些服务在常规临床护理中的应用知之甚少。
本研究纳入了 2005 年至 2008 年间在一家大型德国三级保健医院的 CLS 就诊的所有患者（n=3658）。使用 CL-BaDo 表格记录数据，该表格是用于评估患者的临床特征和 CLS 提供情况的多中心文档表格。采用描述性和推断性统计方法比较了患有黑色素瘤的患者和患有其他皮肤病的患者。
皮肤科医生为其他皮肤病患者请求 CLS 的频率高于为黑色素瘤患者请求 CLS 的频率。这两组患者的转诊原因也不同：黑色素瘤患者因急性应对问题而被转诊的频率更高；其他皮肤病患者因不明原因的身体症状而被转诊的频率更高。此外，后者组被诊断出患有更多和不同的精神和行为障碍。住院期间，黑色素瘤患者接受了更多的心理治疗干预，但在住院后接受进一步的社会心理治疗的建议较少。
这些发现强调了在诊断为黑色素瘤的个体中需要专业的社会心理支持，尤其是在初次诊断或复发时。皮肤科医生在识别患者的需求以及引导他们获得可用的支持服务方面发挥着关键作用。
