Minagawa H, Uchitomi Y, Yamawaki S, Ishitani K
Department of Psychiatry and Neurosciences, Hiroshima University School of Medicine, Japan.
Cancer. 1996 Sep 1;78(5):1131-7. doi: 10.1002/(SICI)1097-0142(19960901)78:5<1131::AID-CNCR26>3.0.CO;2-2.
In the study by Derogatis et al., which included patients with all stages of cancer, 47% of the patients met the DSM-III criteria for a psychiatric disorder, with adjustment disorders being the most common. Although the cancer stage is one factor that influences the nature and incidence of psychiatric disorders, no study has demonstrated the extensive range of psychiatric disorders in terminally ill cancer patients.
Ninety-three terminally ill cancer patients were systematically assessed using the Mini-Mental State Examination (MMSE) and Structured Clinical Interview for DSM-III-R (SCID) within 1 week of admission.
Of this sample population, 53.7% met the DSM-III-R criteria for a psychiatric disorder and 42% had a cognitive impairment. Delirium was observed in 26 patients (28%), dementia in 10 (10.7%), adjustment disorders in 7 (7.5%), amnestic disorder and major depression in 3 (3.2%), and a generalized anxiety disorder in 1 (1.1%).
This preliminary investigation of the prevalence of psychiatric disorders in terminally ill cancer patients showed that more than half of the patients met the criteria for a DSM-III-R psychiatric disorder; delirium was the most common type of psychiatric disturbance. Further prospective trials are critically important to establishing treatment modalities that promote the psychiatric well-being of patients with terminal illnesses.
在德罗加蒂斯等人的研究中，该研究纳入了所有癌症阶段的患者，47%的患者符合精神障碍的《精神疾病诊断与统计手册》第三版（DSM - III）标准，其中适应性障碍最为常见。尽管癌症阶段是影响精神障碍性质和发病率的一个因素，但尚无研究证明晚期癌症患者中精神障碍的广泛范围。
93名晚期癌症患者在入院1周内使用简易精神状态检查表（MMSE）和《精神疾病诊断与统计手册》第三版修订版（DSM - III - R）的结构化临床访谈进行系统评估。
在这个样本群体中，53.7%的患者符合DSM - III - R精神障碍标准，42%有认知障碍。26名患者（28%）出现谵妄，10名（10.7%）出现痴呆，7名（7.5%）出现适应性障碍，3名（3.2%）出现遗忘障碍和重度抑郁，1名（1.1%）出现广泛性焦虑障碍。
对晚期癌症患者精神障碍患病率的这项初步调查表明，超过一半的患者符合DSM - III - R精神障碍标准；谵妄是最常见的精神障碍类型。进一步的前瞻性试验对于确立促进晚期疾病患者精神健康的治疗方式至关重要。
