Levine P M, Silberfarb P M, Lipowski Z J
Cancer. 1978 Sep;42(3):1385-91. doi: 10.1002/1097-0142(197809)42:3<1385::aid-cncr2820420349>3.0.co;2-0.
Records of 100 consecutive hospitalized cancer patients referred for psychiatric consultation were reviewed. These patients constituted only 5% of those seen by the Psychiatry Consultation Service during the study period. Fifty-six percent of the referred patients were diagnosed as depressed and 40% as having organic brain disease. Twenty-six of the 100 patients were misdiagnosed by the referring physician as depressed but were classified by the staff psychiatrist as suffering from organic brain syndrome. When referral was studied by primary site of cancer, only patients with breast cancer were referred at a significantly higher than expected rate (p less than .001). The importance of the mental status examination as a routine procedure in all cancer patients is stressed so that an organic brain syndrome will not be missed. Suggestions for patient management are given.
回顾了连续100例因精神科会诊而住院的癌症患者的记录。这些患者仅占研究期间精神科会诊服务所接待患者的5%。56%的转诊患者被诊断为抑郁症，40%患有器质性脑疾病。100名患者中有26名被转诊医生误诊为抑郁症，但被精神科医生归类为患有器质性脑综合征。当按癌症原发部位研究转诊情况时，只有乳腺癌患者的转诊率显著高于预期（p<0.001）。强调了对所有癌症患者进行精神状态检查作为常规程序的重要性，以免漏诊器质性脑综合征。并给出了患者管理的建议。
