It is necessary to monitor the psychological status of employees in oncology units with scanning tools such as GHQ to understand their job stress perceptions and to help them develop adaptive coping methods.

Background Although the adverse effects of cancer diagnoses and treatments on mental health are known, about less than 10% of patients are estimated to be referred to seek help. The primary purpose of this study was to obtain the baseline information on patients with cancer seeking help for mental health who presented for the first time to the psycho-oncology outpatient clinic, and to identify risk factors that may provide clues healthcare practitioners in recognizing those needing psychological help in oncology practice. Methods We reviewed the charts of 566 patients with cancer who were referred to the psycho-oncology outpatient clinic over a two-year period. The study includes the socio-demographic data, illness characteristics, psychiatric characteristics, psychiatric diagnoses, and treatment recommendations for these patients. Results The incidence of diagnoses of psychiatric disorders was 97.5%. The distributions of psychiatric diagnoses were as follows: any kind of adjustment disorders, mood disorders, anxiety disorders, organic brain syndrome, personality disorders, delusional disorder, and insomnia. Recurrence of cancer, other chronic medical illnesses, a history of psychiatric disorders, poor social support, and low income comprised the common significant risk factors for adjustment disorders, mood disorders, and anxiety disorders. These risk factors were also seen to be significant in the regression analysis in terms of sex. Conclusion This study identifies the distribution of psychiatric disorders, the risk factors for specific psychiatric disorders, and draws attention to the fact that there are serious delays in patients seeking psychiatric help and in the referrals of oncologists for psychological assessment. Identifying risk factors and raising oncologists’ awareness toward risk factors could help more patients gain access to mental health care much earlier.

The aim of the study was to examine the relationship between the levels of somatization, depression as well as alexithymia, and MUS in women going through violence experience in three contexts (childhood, adulthood, and both childhood and adulthood). The study was performed on 180 patients attending the Internal Medicine Department of Istanbul University Medical Faculty. The data of women with MUS (n = 50) were compared those of women with acute physical conditions (n = 46) and chronic physical conditions (n = 84). Semi-structured Interview Form, Childhood Abuse and Neglect Inventory, Brief Symptom Inventory, Beck Depression Inventory, and the Toronto Alexithymia Scale were administered. The levels of somatization and depression were found to be higher in women who were exposed to emotional abuse (EA) and physical abuse (PA) in adulthood in the MUS group compared with those of the women exposed to EA and PA in adulthood in the other groups. The levels of somatization, depression, and alexithymia in the MUS group exposed to childhood emotional abuse (CEA) were also higher than those in the controls exposed to CEA. The levels of somatization and alexithymia in the MUS group who were exposed to childhood physical abuse (CPA) were higher than those in the controls exposed to CPA. The levels of somatization and depression in the MUS group who were exposed to violence both in childhood and in adulthood were higher than those in the controls who experienced violence both in childhood and in adulthood. Most women exposed to domestic violence present to health care institutions with various physical and psychological symptoms in Turkey. So, it is important that health caregivers also ask questions about experiences of violence and psychological symptoms in women presenting with medically unexplained symptoms.

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Providing the patients with negative information about diagnosis, treatment, and prognosis, in other words breaking bad news, is a complicated process for both the patient and the physician. The oncologists often should break the bad news to patients and their relatives. Bad news in the field of oncology often includes the following processes: telling the diagnosis of cancer, providing information about recurrence or metastasis according to the prognosis of the disease, saying that there is nothing left to do medically, and ultimately telling the relatives of the patient the death of the patient. A negative diagnosis or a negative improvement in prognosis should be explained to the patient (sometimes to the patient's relative) with care, empathic and sensitive attitude because a person is emotionally vulnerable while receiving bad news about his/her health or health of a relative. We will focus, in this article, on the importance of breaking bad news as part of clinical practice in oncology, and we will briefly introduce the protocols developed for the proper conduct of breaking bad news and provide information about what the physician should do in the process of breaking bad news by considering the basic features of breaking bad news protocols.