Alexander P J, Dinesh N, Vidyasagar M S
Department of Psychiatry, Kasturba Medical College, Manipal, India.
Acta Oncol. 1993;32(6):623-6. doi: 10.3109/02841869309092441.
Sixty consecutive patients admitted to an oncology unit in a general hospital were systematically assessed to determine the prevalence of psychiatric disorders. Patients' awareness of the diagnosis of cancer and their perception of treatment intention and outcome were assessed independently by another investigator who was blind to the psychiatric diagnosis. Forty percent of the sample had a diagnosis of psychiatric disorder, based on the Diagnostic and Statistical Manual for Mental Disorders (3rd edition, revised). Adjustment disorders comprised most of the psychiatric diagnoses. Major depression was seen in 8 (13%) patients. One third of the patients were estimated to be unaware of the diagnosis of cancer, and 82% of patients perceived the treatment given as curative. Psychiatric morbidity was significantly less common in patients who did not know they had cancer, and in those who considered treatment as curative. The prevalence of depressive disorders in our sample was higher than in medical inpatients. It is concluded that psychiatric disorders, especially affective disorders, are common among cancer patients. Awareness of nature of the illness and expected outcome can affect the prevalence of psychiatric morbidity. Further studies investigating the relationship between psychiatric morbidity and duration of illness, type and stage of cancer, disabilities and coping strategies are warranted.
对一家综合医院肿瘤科室收治的60例连续患者进行系统评估，以确定精神障碍的患病率。由另一位对精神科诊断不知情的研究者独立评估患者对癌症诊断的知晓情况及其对治疗意图和结果的认知。根据《精神障碍诊断与统计手册》（第3版，修订版），40%的样本被诊断为精神障碍。适应性障碍占大多数精神科诊断。8例（13%）患者出现重度抑郁。估计三分之一的患者不知道自己患有癌症，82%的患者认为所接受的治疗具有治愈性。在不知道自己患癌症的患者以及认为治疗具有治愈性的患者中，精神疾病的发生率明显较低。我们样本中抑郁症的患病率高于内科住院患者。得出的结论是，精神障碍，尤其是情感障碍，在癌症患者中很常见。对疾病性质和预期结果的知晓会影响精神疾病的患病率。有必要进一步研究精神疾病患病率与病程、癌症类型和分期、残疾及应对策略之间的关系。
