medigraphic.com
ISSN 0028-3851 (Print)

2005, Number 4

<< Back Next >>

Rev Neurol Neurocir Psiquiat 2005; 38 (4)

Mental disorders in an oncological outpatient’s population with related cancer pain

Almanza MJJ, Breitbart W, Holland JC

Language: Spanish
References: 20
Page: 123-128
PDF size: 182.15 Kb.


ABSTRACT

Background. Up to a third of oncological patients have pain, causing a greater difficult for cancer adaptation as well as several grades of psychopathology, which has been. There are very few studies regarding this correlation in ambulatory cancer patients.
Objective. To describe the mental disorder prevalence in oncological outpatient with related cancer pain.
Setting. Memorial Sloan-Kettering Counseling Center (outpatient facility) at the Memorial Sloan-Kettering Cancer Center, New York, NY.
Method. A retrospective and correlational study was done through chart review. Diagnosed were established using DSM-IV edition criteria. Descriptive, correlational and inferential statistic was performed using c2 for association measures.
Results. A total of 620 patients were studied. Cancer was the primary diagnostic in 523 (85%) and 199 patients (38%) had pain. Documented mental disorder included depressive disorders (62%), adjustment disorders (43.7%), and anxiety disorders (25%). Pain was associated significantly with depression (62.8% vs. 45.5%), anxiety (25% vs. 23.4%), and personality disorders (12.5% vs. 10.5%) (χ2 = 13.4; gl = 3; p = 0.004), and with “urgent” as well as “today” modality of liaison consultation (8.5% vs. 6.9% y 23% vs. 12.8%) (χ2 = 17.3; gl = 3; p = 0.004), whereas “routine” was more frequent in patients without pain (80.3% vs. 67.5%). Finally, cancer pain comorbidity causes more probability to receive pharmacologic treatment (74% vs. 57.3%, p =.001), or psychotherapy (83% vs. 77.8%, p =.000) and less probability of clinical global improvement as compared with patients without pain (53% vs. 58%, p=.000).
Conclusions. Cancer and pain coexistence in 38% associated significantly with psychopathology as well as with needs for a psychopharmacotherapy, psychotherapy and less probability of clinical global improvement, such features must aware the oncological team to early detection and management of such clinical conditions. It is recommended to replicate this study to confirm the consistence of these features in other oncological patients’ samples and with more advanced methodological design.


REFERENCES

  1. Massie MJ, Holland JC. The cancer patient with pain, psychiatric complications and their management. J Pain Symptom Manage 1992; 7(2): 99-109.

  2. Parkim DM, Laara E, Muir CS. Estimates of the worldwide frequency of sixteen major cancers in 1980. Int J Cancer 1988; 41: 184-97.

  3. Derogatis LR, Morrow GR, Fetting D, et al. The prevalence of psychiatric disorders among cancer patients. JAMA 1983; 249: 751-7.

  4. Holland JC. Psychooncology. New York: Oxford University Press; 1998.

  5. Breitbart W, Payne DK. Pain. In: Holland JC. Psychooncology. New York: Oxford University Press; 1998.

  6. Foley KM. Pain syndromes in patients with cancer. Medical Clin North Am 1987; 71(2): 169-84.

  7. Rao A, Cohen HJ. Symptom management in the elderly cancer patient, fatigue, pain, and depression. J Natl Cancer Inst Monogr 2004; (32): 150-7.

  8. Ahles TA, Blanchard EB, Ruckdeschel JC. The multidimensional nature of cancer-related pain. Pain 1983; 17: 277-88.

  9. Payne R. Pathophysiology of cancer pain. Advances in cancer pain and therapy. Vol 16. In. Foley KM, Bonica JJ, Ventafridda V, Callaway MV. Proceedings of the Second International Congress on Cancer Pain. New York: Raven Press. Ltd.; 1990.

  10. Almanza J, Breitbart W, Holland J. Pain characteristics and management in outpatients with cancer. Psychooncology 1999; 8(Suppl 6): 60.

  11. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th Ed. Washington D.C.: American Psychiatric Association; 1994.

  12. Miaskowski C. Gender differences in pain, fatigue, and depression in patients with cancer. J Natl Cancer Inst Monogr 2004; (32): 139-43.

  13. Murphy GP, Lawrence W, Lenhard RE. American Cancer Society textbook of Clinical Oncology. 2nd Ed. Atlanta, Georgia: The American Cancer Society Inc.; 1996.

  14. Stefanek ME, Derogatis LP, Shaw A. Psychological distress among oncology outpatients. Psychosomatics 1987; 28(10): 530-2.

  15. Peteet J, Tay V, Cohen G, MacIntyre J. Pain characteristics and treatment in an outpatient cancer population. Cancer 1986; 57(6): 1259-65.

  16. Bond MR. The relation of pain to the Eysenck personality inventory. Cornel Medical Index and Whiteley Index of hypocondriasis. Brit J Psychiat 1971; 119: 671-8.

  17. American Pain Society Quality of Care Committee. Quality improvement guidelines for the treatment of acute pain and cancer pain. JAMA 1995; 274: 1874-80.

  18. Shuterland AM, Orbach CE, Dyk RB, Bard M. The psychological impact of cancer and cancer surgery: I. Adaptation to the dry colostomy: Preliminary report and summary of findings. Cancer 1952; 5: 857-72.

  19. Smith MT, Perlis ML, Haythornthwaite JA. Suicidal ideation in outpatients with chronic musculoskeletal pain, an exploratory study of the role of sep onset insomnia and pain intensity. Clin J Pain 2004; 20(2): 111-8.

  20. Theobald DE. Cancer pain, fatigue, distress, and insomnia in cancer patients. Clin Cornestone 2004; 6 (Suppl 1D): s15-21.




2020     |     www.medigraphic.com