Mental disorders in cancer patients.A study of 100 psychiatric referrals

Abstract

Records of 100 consecutive hospitalized cancer patients referred for psychiatric consultation were reviewed. These patients constituted only 5% of those seen by the Psychiatry Consultation Service during the study period. Fifty-six percent of the referred patients were diagnosed as depressed and 40% as having organic brain disease. Twenty-six of the 100 patients were misdiagnosed by the referring physician as depressed but were classified by the staff psychiatrist as suffering from organic brain syndrome. When referral was studied by primary site of cancer, only patients with breast cancer were referred at a significantly higher than expected rate (p less than .001). The importance of the mental status examination as a routine procedure in all cancer patients is stressed so that an organic brain syndrome will not be missed. Suggestions for patient management are given.

Cognitive deficits associated with cancer: A model of subjective and objective outcomes

“…Affective symptoms in people with cancer may indicate underlying neurological deficits (Oxman & Silberfarb, 1987). In one series of 100 consecutive psychiatric referrals from an oncology service, 40 people showed evidence of an organic brain syndrome and, importantly, 26 of these had not been recognized by the referring physician (Levine, Silberfarb, & Lipowski, 1978).…”

A manic episode associated with bereavement in a patient with lung cancer

“…In a study of 100 hospitalized cancer patients referred to a psychiatric liaison service, 56% of the patients referred were diagnosed as being depressed and 40% as having organic brain disease [7]. Adjustment disorders were most commonly recognized in newly admitted patients in a series of 215 cancer patients [3].…”

Central nervous system toxicity from cancer treatment

“…The presence of a primary or secondary brain tumor or evidence of leptomeningeal disease should also be ascertained. Levine et al [28] reported that 64% of cancer patients with delirium were misdiagnosed with depression. This propensity for misdiagnosis and the avoidance of diagnosing behavioral abnormalities can have serious consequences and actually worsen the patient's condition if inappropriate treatment is initiated [29].…”