Mental Health
Services Underutilized by Cancer Patients
Behind the Cancer Headlines®
The prevalence of major psychiatric disorders is as common
in cancer patients as they are in the general population, with the exception of
panic disorder which had elevated rates compared to the general population (5
percent versus 1.7 percent, respectively). However, fewer than half of advanced
cancer patients with major psychiatric complaints receive care from a mental
health provider, according to a study published in the journal Cancer.
The study, one of the first to relate prevalence and use of mental health services and terminal cancer patients, suggests that Caucasian patients and patients who discuss their psychiatric complaints are more likely to receive care.
Cancer patients have several factors that contribute to emotional distress. Psychiatric disorders left untreated in terminal cancer patients have been demonstrated to worsen the quality of life in such areas as pain control and physical disability, adversely affect treatment compliance and shorten survival. Data suggest that the prevalence of psychiatric disorders in early stage cancer patients is far less than advanced stage cancer patients. However, the prevalence of psychiatric disease in the latter is poorly understood, with estimates varying from 3 to 38 percent. In order to improve the quality of life in advanced cancer patients, researchers set out to understand the extent of the problem of psychiatric disease and how mental health services are being utilized.
First author, Nina S. Kadan-Lottick,
M.D., M.S.P.H. of the Yale University School of Medicine and the
The authors found that about one in ten (12 percent) of 251 patients with advanced cancer met DSM-IV criteria for a current major psychiatric disorder - a prevalence rate similar to the general population. A little over one in four (28 percent) had received mental health treatment since being diagnosed with cancer, and about one in six (17 percent) had talked with a mental health provider. Conversely, more than half (55 percent) of advanced cancer patients with psychiatric complaints had not accessed mental health services. Factors that predicted use of mental health services included race (Caucasians in particular) and most importantly, patients who had discussed emotional complaints with staff.
"Our study," write the authors, "identified
the underutilization of mental health services among advanced cancer
patients." They conclude, "Discussion of mental health issues with a
health care provider allows distress to be detected and is the most important
predictor of whether services will be received."
SOURCE:
Cancer,