Factors important to psychosocial adjustment to cancer: a review of the evidence.

Aim: To study the prevalence of Psychiatric disorders in cancer patients and to find out the factors associated with Psychiatric disorders in Cancer Patients. Settings and Design: Department of Radiotherapy, Medical College, Thiruvananthapuram, cross sectional survey design was used. Methods and Material: Adult patients (18 years of age and above), having a diagnosis of carcinoma were selected by consecutive sampling method.A questionnaire which included back ground data, socio economic variables, treatment variables like type of malignancy, exposure to radiation & chemotherapy prior to the evaluation and current treatment, co occurring medical illness & treatment and past & family history of psychiatric illness was used to collect data. Delirium rating scale and MINI International neuropsychiatric interview were used to assess Psychiatric disorders and delirium. Statistical Analysis Used: Chi square and logistics regression tests were used for analysis. Results: Of the 384 assessed, 160(41.7%) had psychiatric disorders. Adjustment disorders were seen in 22.6%. 10.9% of subjects had major depressive disorder. Thus a total of 33.5% of patients had a diagnosis of either anxiety or depressive disorder. Proportion of patients having delirium was 6.5%. Hypomania was seen in small (1.6%) of patients. Multivariate analysis for various parameters for psychiatric disorders showed that age, past history of chemotherapy, past history of radiotherapy, & surgical treatment of carcinomas are significant predictors of psychiatric disorders. Conclusions: Psychiatric disorders are seen in a significant proportion of Psychiatric patients.

Prevalence of psychiatric morbidity among cancer patients – hospital-based, cross-sectional survey

The majority of cancers affect older persons disproportionately and the probability of developing cancer increases dramatically with age. We compared psychological and functional adaptation as well as psychosocial coping resources and service use between two age cohorts: patients under 65 and patienis 65 and over with a diagnosis of breast, colorectal or lung cancer. Older patients were not seriously disadvantaged in terms of adaptation or coping resources, although results suggest that they may be underutilizers of supportive community services. Practical and theoretical implications are discussed.

Coping with Cancer

As more elderly people experience a cancer diagnosis and live longer, the psychological sequelae of the disease and its treatment increasingly becomes a central concern. Cancer and its treatment are likely to present significant adaptive challenges to the elderly. Knowledge of the correlates of depressive symptoms in older patients may help to identify patients who are at increased risk for co-morbid depression and to inform the development of programs and services that can help reduce depressive symptoms. Data from 169 outpatients with cancer (aged 60 to 86 years) were included in an analysis to estimate a model of patients' depressive symptoms using the Center for Epidemiologic Studies Depression Scale. The results of regression analyses indicated that a college degree and a lesser impact of the disease on patients' social functioning correlated with lower depression and that feeling separated or set apart from others and a wider range of negative interactions with one's support network correla...

Elderly cancer patients : Correlates of depressive symptomatology

Cancer and its treatment is known to have a substantial psychological morbidity and, while adjuvant psychological therapy (APT) is well established, relatively little work has been done to investigate the effectiveness of psychotherapy, particularly cognitive behaviour therapy (CBT), for patients with cancer



This article focuses initially on emotional responses to the diagnosis of cancer, individual vulnerability and the prevalence of psychological problems in patients with cancer The use of cognitive behaviour therapy is then described, together with key issues in its application and specific problems The work concludes by considering differences in applying CBT to patients with cancer compared to patients with other physical illnesses and the notion of ‘relapse inoculation’

Cancer, emotional responses and cognitive behavioural psychotherapy

A clinically derived system of judging cancer patients' engagement, reality testing and degree of arousal during a pretreatment consultation was found predictive of psychosocial problems or no problems reported by sixty cancer patients one month after starting radiation therapy. Independent ratings of psychosocial problems by the treating oncologists, nurses and radiation therapists three months after starting treatment were also found significantly associated with the pretreatment composite.Disease, treatment and demographic factors were not predictive of psychosocial problems and were not associated with the pretreatment clinical composite.Follow-up observations at six months and eighteen to twenty-four months of forty-four and twenty-four of the original patients available for study revealed there was no continuing association between their pretreatment clinical composites and psychosocial problem ratings.

Ardis Davis

Papers

Pretreatment Behavioral Profiles Associated with Subsequent Psychosocial Adjustment in Radiation Therapy Patients: A Prospective Study: