Impact of serious mental illness on the treatment and mortality of older patients with locoregional high‐grade (nonmetastatic) prostate cancer: retrospective cohort analysis of 49 985 SEER‐Medicare patients diagnosed between 2006 and 2013

Fried, Dennis; Sadeghi‐Nejad, Hossein; Gu, Dian; Zhou, Shouhao; He, Weiguo; Giordano, Sharon H.; Pentakota, Sri Ram; Demissie, Kitaw; Helmer, Drew A.; Shen, Chan

doi:10.1002/cam4.2109

Cited by 16 publications

(24 citation statements)

References 29 publications

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“…This discrepancy may be explained by the diversity of sample populations and variations in both the diagnostic criteria and the specialists who made the diagnoses. Nevertheless, our result suggests that the prevalence of major psychiatric disorders among patients with degenerative thoracic or lumbar spine disease requiring surgical intervention is underestimated, perhaps because of the underdetection of psychiatric comorbidities or the relatively lower surgical rate in patients with preexisting psychiatric disorders [ 34 ]. Clinicians are advised to be aware of patients’ mental state in evaluating them for spine surgery.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Outcomes of Major Psychiatric Disorders Preceding Index Surgery for Degenerative Thoracic/Lumbar Spine Disease

Huang

Chang

Lin

et al. 2021

IJERPH

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The relationship between preexisting major psychiatric disorders and outcomes of spine surgery for degenerative thoracic/lumbar disease remains unclear. A 5% subset of inpatients was randomly selected from the Taiwan National Health Insurance Research Database. A total of 10,109 inpatients aged 18 years or over with degenerative thoracic/lumbar disease and underwent spine surgery met inclusion criteria. Major psychiatric disorders diagnosed by psychiatrists preceding index surgery, including anxiety disorder, depression disorder, bipolar disorder, schizophrenia and dementia, were identified. The prevalence of psychiatric disorders, and their differential risks on in-hospital and post-discharge outcomes were examined. 10.4% had major psychiatric disorders, of which depression (6.6%) and anxiety (4.9%) were most common. Logistic regression revealed increased risks of ventilator use in depression (OR = 1.62, 95% CI = 1.04–2.54, p < 0.05), extended hospitalization length in bipolar (OR = 1.77, 95% CI = 1.08–2.89, p < 0.05), and higher rehabilitation utilization in depression (OR = 1.25, 95% CI = 1.06–1.47, p < 0.01) and bipolar (OR = 1.69, 95% CI = 1.04–2.76, p < 0.05). Those patients with anxiety had a decreased risk of longer hospitalization duration (OR = 0.77, 95% CI = 0.60–0.98, p < 0.05), while those with dementia and schizophrenia had no change in risks. Preoperative recognition of major psychiatric disorders for risk and treatment assessment is suggested as people with preexisting depression or bipolar disorder have worse outcomes after spine surgery.

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Section: Discussionmentioning

confidence: 99%

Prevalence and Outcomes of Major Psychiatric Disorders Preceding Index Surgery for Degenerative Thoracic/Lumbar Spine Disease

Huang

Chang

Lin

et al. 2021

IJERPH

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“…Additionally, SMI was associated with higher hazard of 5-year cancer-specific death after accounting for competing risks of non-cancer death. 42 Again, in an Australian study, although the incidence of cancer was not higher than in the general population, psychiatric patients were more likely to have metastases at diagnosis and less likely to receive specialized interventions, with a greater case fatality. 43 Similar results were found in a study of 16 636 elderly women in which patients with comorbid anxiety and depression had an increased risk for diagnosis delay of ≥90 days from symptom recognition, and those with severe mental illness had an increased risk for initial treatment delay of ≥60 days from diagnosis.…”

Section: Incidence Of Cancer and Cancer Mortality In People With Smimentioning

confidence: 93%

“…With respect to prostate cancer, a study of 49 985 patients with locoregional high‐grade (nonmetastatic) cancer showed that having a SMI (bipolar disorder, schizophrenia, and other psychotic disorders) was associated with reduced odds of receiving surgery or radiation concurrent with hormone therapy as initial treatments in the year after diagnosis. Additionally, SMI was associated with higher hazard of 5‐year cancer‐specific death after accounting for competing risks of non‐cancer death 42 . Again, in an Australian study, although the incidence of cancer was not higher than in the general population, psychiatric patients were more likely to have metastases at diagnosis and less likely to receive specialized interventions, with a greater case fatality 43 .…”

Section: Incidence Of Cancer and Cancer Mortality In People With Smimentioning

confidence: 94%

Cancer and severe mental illness: Bi‐directional problems and potential solutions

Grassi

Riba

2020

Psycho-Oncology

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Objective: Given the reported increased rates of physical morbidity and higher mortality rates among people with severe mental illness (SMI) (schizophrenia and severe mood disorders), with a life expectancy shorter of 15-20 years with respect to the general population, the aim of this paper was to call attention to the problem of cancer in SMI. Methods: We conducted a narrative review of the most significant papers published in the areas of cancer screening, incidence, mortality and palliative care in SMI. Results: Data from the literature confirm disparities in screening (eg, mammography; pap-smear test; colorectal cancer screening) and prevention (eg, clinical breast examination; smoking cessation). The incidence of cancer was found to be variable with a portion of the studies reporting a higher prevalence while others a similar or a lower prevalence of cancer compared to the general population. A lower percentage of patients with SMI received proper cancer treatment resulting in survival after cancer diagnosis significantly worse than people without SMI. Likewise, end-of-life care has been shown to be lacking with poorer levels of physical, psychological and spiritual care. Conclusions: The problems of stigma and discrimination, poorer dignity, poorer health behavior, lack of integration in health-care services for people with SMI needs to be addressed and solved in cancer care. Psycho-oncology has a very specific and mandatory role in integrating the recommendation of the World Health Organization to improve the links between oncology and mental health settings for more specific psycho-oncology programs addressed for this vulnerable segment of the population.

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“…Tuesley et al reported low frequency of prostate cancer screening among men with severe mental illness, and suggested that screening non-participation “may explain some of the mismatch between cancer incidence and mortality in people with severe mental illness” [ 40 ]. Fried et al found that serious mental illness in men with non-metastatic prostate cancer was associated with receipt of less aggressive treatment and worse cancer-specific survival [ 41 ]. In Sweden, PSA testing is performed on the individual’s own initiative and may be under-utilized by men with DUD.…”

Section: Discussionmentioning

confidence: 99%

Drug use disorder and risk of incident and fatal prostate cancer among Swedish men: a nationwide epidemiological study

Dahlman

Crump

et al. 2021

Cancer Causes Control

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Purpose Prostate cancer is the second most common cancer in men and a leading cause of cancer mortality worldwide. Men with drug use disorders (DUD) may potentially be at high risk for prostate cancer mortality because of delayed diagnosis and/or undertreatment. In this study, we aimed to investigate prostate cancer incidence, mortality, and stage at time of diagnosis among men with DUD compared to the general male population in Sweden. Methods We performed a follow-up study based on Swedish national register data for the period January 1997–December 2016. The study was based on 1,361,532 men aged 50–75 years at inclusion, of whom 9,259 were registered with DUD. Cox regression analysis was used to compute adjusted hazard ratios (HRs) for incident and fatal prostate cancer, and cancer stage at time of diagnosis, associated with DUD. Results DUD was associated with a slightly increased risk of incident prostate cancer (HR: 1.07, 95% confidence interval [CI] 1.00–1.14, p = 0.048) and substantially higher risk of fatal prostate cancer (HR: 1.59, 95% CI 1.40–1.82, p < 0.001), adjusted for age, socioeconomic factors, and comorbidities related to tobacco smoking and alcohol use disorder. No association was found between DUD and prostate cancer stage at diagnosis. Conclusions Men with DUD have an increased risk of fatal prostate cancer, possibly related to undertreatment in this patient population. Our findings should raise attention among medical staff and decision-makers towards a disadvantaged group of men in need of easily accessible prostate cancer evaluation and treatment.

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Impact of serious mental illness on the treatment and mortality of older patients with locoregional high‐grade (nonmetastatic) prostate cancer: retrospective cohort analysis of 49 985 SEER‐Medicare patients diagnosed between 2006 and 2013

Cited by 16 publications

References 29 publications

Prevalence and Outcomes of Major Psychiatric Disorders Preceding Index Surgery for Degenerative Thoracic/Lumbar Spine Disease

Prevalence and Outcomes of Major Psychiatric Disorders Preceding Index Surgery for Degenerative Thoracic/Lumbar Spine Disease

Cancer and severe mental illness: Bi‐directional problems and potential solutions

Drug use disorder and risk of incident and fatal prostate cancer among Swedish men: a nationwide epidemiological study

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