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癌症与严重精神疾病的棘手问题。

The Challenging Problems of Cancer and Serious Mental Illness.

作者信息

Grassi Luigi, McFarland Daniel, Riba Michelle, Ferrara Maria, Zaffarami Giulia, Belvederi Murri Martino, Cruciata Marco, Caruso Rosangela

机构信息

Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Via Fossato di Mortara 64a, Ferrara, 44121, Italy.

University Hospital Psychiatric Unit, S. Anna Hospital and Local Health Trust, Ferrara, Italy.

出版信息

Curr Psychiatry Rep. 2025 Jan;27(1):41-57. doi: 10.1007/s11920-024-01570-9. Epub 2025 Jan 9.

Abstract

PURPOSE OF REVIEW

Patients with Serious Mental Illness (SMI) are reported to be at higher risk for somatic disorders (e.g. cardiovascular and metabolic diseases) and higher mortality, compared to the general population, because of the consequences of SMI including psychotropic medication side effects, sedentary and unhealthy lifestyle, difficult access to physical health care. The aim of this review was to examine the current evidence regarding oncology, focusing on the problem of cancer among patients with SMI. RECENT FINDINGS: Compared to the general population, individuals with SMI showed a lower rate of screening for cancer, suboptimal standard cancer treatment, delayed treatment, and higher mortality from cancer. Several factors, including those related to the patient, the health-care system, and the social context, are involved in these negative outcomes. It is therefore necessary to raise awareness and alert clinicians in oncology settings to the challenging problem of cancer among patients with SMI, a marginalized and vulnerable segment of the population that can be at risk for not receiving proper cancer prevention and care. Evidence supports the mandatory need for an interdisciplinary approach involving psychiatry and mental health services.

摘要

综述目的

据报道,与普通人群相比,严重精神疾病(SMI)患者患躯体疾病(如心血管和代谢疾病)的风险更高,死亡率也更高,原因包括SMI的后果,如精神药物副作用、久坐和不健康的生活方式、难以获得身体健康护理。本综述的目的是研究当前关于肿瘤学的证据,重点关注SMI患者中的癌症问题。最新发现:与普通人群相比,SMI患者的癌症筛查率较低、标准癌症治疗不理想、治疗延迟且癌症死亡率较高。包括与患者、医疗保健系统和社会背景相关的因素在内,多种因素导致了这些负面结果。因此,有必要提高认识,并提醒肿瘤学环境中的临床医生注意SMI患者中具有挑战性的癌症问题,这是一个被边缘化且易受伤害的人群,可能面临无法获得适当癌症预防和护理的风险。有证据支持采用涉及精神病学和心理健康服务的跨学科方法的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0df/11724792/515e67e26fa3/11920_2024_1570_Fig1_HTML.jpg

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