Service de Psychiatrie et Addictologie de l'adulte et du sujet âgé, AP-HP, Hôpital Européen Georges Pompidou, 75015, Paris, France.
Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, 75004, Paris, France.
Support Care Cancer. 2024 Aug 27;32(9):614. doi: 10.1007/s00520-024-08806-7.
Among patients with cancer, a comorbid mental disorder is associated with higher mortality. This could be partially attributed to reduced access to oncological care, sometimes due to treatment refusal. Recommendations were issued in 2018 by the French and Francophone Society of Psycho-Oncology concerning the management of oncological treatment refusal. This study aimed to examine oncology residents' view on psychiatric assessment in this context.
In February 2021, we conducted a descriptive, observational, cross-sectional pilot study among French residents involved in oncology regarding their management of cancer treatment refusal and the importance they assign to psychiatric assessment, using an online questionnaire with 12 multiple-choice questions.
Among 87 respondents, only 35.6% systematically explore the history of mental disorders when facing cancer treatment refusal. Even in cases with a known history of mental disorders, only 42.5% systematically refer the patient to a psychiatrist. 96.5% of them were unaware of the 2018 recommendations.
The importance given to psychiatric assessment in cases of oncological treatment refusal remains insufficient. Qualitative studies are needed to understand the underlying reasons for this refusal. The development of psychiatric consultation-liaison interventions in oncology centers is necessary to improve the management of these cases and provide appropriate training.
在癌症患者中，合并精神障碍与更高的死亡率相关。这可能部分归因于获得肿瘤治疗的机会减少，有时是因为治疗拒绝。法国和法语国家心理肿瘤学会在 2018 年就肿瘤治疗拒绝的管理发布了建议。本研究旨在调查肿瘤学住院医师在这种情况下对精神评估的看法。
2021 年 2 月，我们对参与肿瘤学的法国住院医师进行了一项描述性、观察性、横断面的初步研究，内容是他们对癌症治疗拒绝的管理以及他们对精神评估的重视程度，使用包含 12 个多项选择题的在线问卷。
在 87 名受访者中，只有 35.6%在面对癌症治疗拒绝时系统地探讨精神障碍史。即使在已知有精神障碍史的情况下，也只有 42.5%系统地将患者转介给精神科医生。他们中的 96.5%不知道 2018 年的建议。
在肿瘤治疗拒绝的情况下，对精神评估的重视程度仍然不足。需要进行定性研究来了解这种拒绝的潜在原因。有必要在肿瘤中心开展精神科联络干预，以改善这些病例的管理并提供适当的培训。
