Grassi Luigi, Riba Michelle B
Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy.
University Hospital Psychiatric Unit, S. Anna Hospital, Ferrara, Italy.
Psychooncology. 2021 Dec;30(12):1997-2001. doi: 10.1002/pon.5853.
People with severe mental illness (SMI) are at extreme risk of being stigmatized and to receive poor quality physical care. It has been demonstrated that they have higher morbidity and poorer prognosis of several medical diseases than the general population, with an at least 10-20-year reduction in life expectancy.
A special issue of Psycho-Oncology focusing on cancer care among patients affected by SMI was called by the Editorial Board of the journal, with the aim to explore cancer health disparities and inequalities among people with SMI, mortality from cancer, problems of communication between multidisciplinary oncology and psychiatric teams and need for more structured intervention (i.e., screening, prevention, treatment).
Authors from eight countries contributed. The problem of stigma and barriers to cancer care provision for patients with SMI were studied (e.g., the complex nature of SMI and healthcare providers' misunderstanding of SMI). Key barriers were related to both patients, clinicians and institutional problems, such as fragmentation of care. A higher mortality from cancer and poor knowledge about cancer risk-factors was shown in patients with SMI. Models of intervention were also proposed.
Several conclusions have been recommended by the authors, such as the need for guidelines and clinical procedures specific for cancer care in mental health settings; large-scale studies to address the disparities of care in people with SMI; a larger vision of psychosocial oncology as the facilitator of the liaison between oncology and psychiatry.
重度精神疾病（SMI）患者面临极高的被污名化风险，且接受的躯体护理质量较差。已证实，他们患多种躯体疾病的发病率更高，预后更差，预期寿命至少缩短10 - 20年。
该期刊编辑委员会发起了一期《心理肿瘤学》特刊，聚焦受SMI影响患者的癌症护理，旨在探讨SMI患者之间的癌症健康差异与不平等、癌症死亡率、多学科肿瘤学与精神科团队之间的沟通问题以及对更结构化干预（即筛查、预防、治疗）的需求。
来自八个国家的作者投稿。研究了SMI患者的污名问题以及癌症护理提供方面的障碍（例如，SMI的复杂性以及医疗服务提供者对SMI的误解）。关键障碍与患者、临床医生以及机构问题相关，比如护理碎片化。SMI患者显示出更高的癌症死亡率以及对癌症风险因素的了解不足。还提出了干预模式。
作者们提出了若干结论，比如需要针对心理健康环境中癌症护理的指南和临床程序；开展大规模研究以解决SMI患者的护理差异问题；将心理社会肿瘤学视为肿瘤学与精神病学之间联络促进者的更宏观愿景。
