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重度精神疾病患者患癌风险及病程

The Risk and The Course of Cancer Among People with Severe Mental Illness.

作者信息

Grassi Luigi, McFarland Daniel, Riba Michelle

机构信息

Department of Neuroscience and Rehabilitation, DInstitute of Psychiatry, University of Ferrara and University Hospital Psychiatric Unit, Ferrara, Italy.

Department of Medicine, Hofstra University, Northwell Health, Lenox Hill Hospital, New York, NY, US.

出版信息

Clin Pract Epidemiol Ment Health. 2023 Dec 3;19(Suppl-1):e174501792301032. doi: 10.2174/17450179-v17-e211208-2021-HT2-1910-8. eCollection 2023.

Abstract

The paucity of data regarding patients with Serious Mental Illness (SMI) and cancer is alarming given the fact that people with SMI, especially schizophrenia, bipolar disorders and severe depressive disorders, have in general poorer access to physical health care and higher morbidity and mortality because of physical illnesses. The aims of this review were to examine the current evidence from existing literature on the risk of developing cancer and its course among people with SMI. Equivocal results emerge regarding the risk of developing some kind of cancer among people with SMI, with contrasting data on a possible higher, similar or lower risk in comparison with the general population. In contrast, a series of studies have pointed out that patients with SMI who develop cancer are less likely to receive standard levels of cancer care, both in terms of screening, diagnosis and treatment. Also, the mortality for cancer has been confirmed to be higher than the general population. A global sensitization about these problems is mandatory in an era in which community psychiatry has been developed in all countries and that policies of prevention, treatment, follow up, and palliative care should regard all the segments of the population, including people with SMI, through an interdisciplinary approach.

摘要

鉴于患有严重精神疾病(SMI)的人,尤其是精神分裂症、双相情感障碍和重度抑郁症患者,通常获得身体健康护理的机会较少,且由于身体疾病导致的发病率和死亡率较高,关于SMI患者和癌症患者的数据匮乏令人担忧。本综述的目的是研究现有文献中关于SMI患者患癌风险及其病程的当前证据。关于SMI患者患某种癌症的风险,出现了模棱两可的结果,与普通人群相比,关于可能更高、相似或更低风险的数据相互矛盾。相比之下,一系列研究指出,患癌症的SMI患者在筛查、诊断和治疗方面不太可能接受标准水平的癌症护理。此外,已证实癌症死亡率高于普通人群。在所有国家都已发展社区精神病学的时代,必须对这些问题进行全球宣传,预防、治疗、随访和姑息治疗政策应通过跨学科方法关注包括SMI患者在内的所有人群。

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