Terminal Illness and Schizophrenia

Kelly, Brendan D.; Shanley, David

doi:10.1177/082585970001600210

Cited by 10 publications

(17 citation statements)

References 14 publications

(5 reference statements)

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“…This theme was categorized into 3 subthemes: end-oflife care decisions, ability to understand a terminal illness, and substitute decision makers (SDMs). Systematic literature review B1 C6 Chochinov et al 13 Cohort study, N ¼ 26 004 A1 C2 Clements-Cortés 28 Case study, N ¼ 3 C 1 D 1 Ganzini et al 25 Cross-sectional study, N ¼ 256 B3 Geppert et al 27 Case study, N ¼ 1 B3 C1, C5 D1 Griffith 40 Case study, N ¼ 1 C 7 Griffith 30 Case study, N ¼ 1 C1, C2, C4, C6 Irwin et al 14 Literature review, N ¼ 1 A1, A2 B1 C2 D4 Kelly and Shanley 34 Case study, N ¼ 1 C1, C2, C3, C5 Lent and Brown-Bradley 39 Case study, N ¼ 1 C 6…”

Section: Theme 1: Stigmamentioning

confidence: 99%

“…14,29,31 Medication intervention is best used when the patient has a history of positive responses to a medication with few side effects. 34 Close medication monitoring is required for individuals who are receiving medication for psychotropic and pain symptom management due to possible medication interactions. 17,23,30 Furthermore, research demonstrated that individuals diagnosed with schizophrenia, most specifically those diagnosed with cancer, were less likely to obtain prescriptions to relieve pain, leading to a lower quality of care.…”

Section: Theme 3: Best Practicesmentioning

confidence: 99%

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On the Margins of Death: A Scoping Review on Palliative Care and Schizophrenia

et al. 2018

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Schizophrenia is a serious chronic mental illness that results in marginalization and stigma for sufferers. It is the seventh leading cause for disability worldwide. The symptoms of the illness, including hallucinations, delusions, and extremely disordered thinking and behavior, may also introduce barriers to accessing treatment, education, housing, and employment. Little is known about endof-life care for individuals with schizophrenia. To address this gap, a scoping review was conducted to enhance understanding of hospice and palliative care for patients with schizophrenia. From this scoping review, 342 unique titles and abstracts were identified through a search of 20 databases, including 11 social science databases, 6 medical databases, and 3 gray literature databases. A total of 32 articles met the inclusion criteria and the following 4 themes were identified: 1. Stigma affecting quality of care and access to care; 2. Issues related to consent and capacity for the patient's end-of-life care decisions and to appoint substitute decision makers; 3. Best practices for psychosocial interventions, pharmacology, family and health-care collaborations, goals of care, setting, and smoking; and 4. Barriers to care, including setting, communication, provider education, and access to care. The review suggests the importance of mandatory interdisciplinary training practices and policy standards outlining cooperative communication across health-care providers. It highlights gaps in evidence-based research on psychosocial interventions and collaborative frameworks to enable the provision of quality end-of-life care for individuals with schizophrenia.

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Section: Theme 1: Stigmamentioning

confidence: 99%

Section: Theme 3: Best Practicesmentioning

confidence: 99%

On the Margins of Death: A Scoping Review on Palliative Care and Schizophrenia

et al. 2018

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“…This group is expected to grow as the population ages as well, and its psychiatric treatment must be addressed. The general consensus has been that quality research with which to make informed practice and policy decisions is wanting [7,[70][71][72][73][74][75].…”

Section: Discussionmentioning

confidence: 99%

A Research Study Review of Effectiveness of Treatments for Psychiatric Conditions Common to End-Stage Cancer Patients: Needs Assessment for Future Research and an Impassioned Plea - A Commentary and Controversy

Johnson¹

2019

Health Care Current Reviews

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The end stage cancer involves particular psychiatric conditions and their treatments that have varying degrees of effectiveness. This Commentary article covers a recent comprehensive and detailed literature review research study report centered on treatment effectiveness that also includes a methodological controversy and its resolution in which the study was involved. The resolution of this methodological controversy and mixed-method approach has far reaching implications for how these kind of studies are conducted in the future. Which have substantial power to inform mental health administration and policy making. This commentary also reviews important highlights from the studies' conclusions.

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“…In such cases, patients with somatic complications often need treatment in a psychiatric ward in the general hospital 7 . In other cases, when psychiatric symptoms are mild, attending psychiatrists may treat schizophrenia patients in the general ward using the consultation–liaison service 5 . In particular, patients with schizophrenia who have cancer often have a variety of complicated medical and psychiatric problems.…”

Section: Discussionmentioning

confidence: 99%

“…Often these patients can neither understand the diagnosis of cancer nor cooperate with treatment because of severe psychiatric symptoms or cognitive impairment. Even when patients accept the diagnosis and undergo cancer treatment and/or long‐term palliative treatment, they need assistance in achieving psychiatric stability and in understanding their disease 5 …”

Section: Introductionmentioning

confidence: 99%

Factors disturbing treatment for cancer in patients with schizophrenia

Inagaki

Yasukawa

Okazaki

et al. 2006

Psychiatry Clin Neurosci

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Patients with schizophrenia who develop cancer often have a variety of complicated medical and psychiatric problems. Problems associated with receiving a diagnosis of cancer and with understanding or cooperating with medical treatment may develop. Research in managing and treating schizophrenia patients with cancer is scarce. Presented herein is the experience of the authors' consultation-liaison psychiatry service in treating patients with schizophrenia who have cancer, and discussion of the medical management of such cases. Fourteen patients were treated between April 1999 and March 2003 and included patients receiving consultation psychiatric services at Shimane University Hospital as well as patients referred from other psychiatric hospitals. These patients were divided into two groups based on whether they were amenable to cancer treatment or not. The treated group consisted of patients who accepted cancer treatment, and the untreated group consisted of patients who refused or interrupted the cancer treatment. The clinical course, clinical psychiatric symptoms, problems in understanding cancer, cancer treatment course and convalescence were retrospectively assessed. Psychiatric symptoms and state were measured using the Brief Psychiatric Rating Scale (BPRS) and the Positive and Negative Syndrome Scale (PANSS). The mean of the duration of schizophrenia in these two groups was not significantly different. The mean scores on measures of psychiatric symptoms in each group (treated and untreated) were as follows: BPRS, 45.3 ± 15.4 and 64.9 ± 9.2 ( P < 0.05); positive symptoms scores on PANSS, 14.4 ± 8.8 and 20.6 ± 6.0 (NS); negative symptoms scores on PANSS, 20.6 ± 4.7 and 33.6 ± 4.4 ( P < 0.01); and total scores on PANSS, 31.7 ± 7.0 and 48.6 ± 7.4 ( P < 0.01). Patients with severe negative symptoms had greater difficulty understanding and cooperating with the cancer treatment. Regarding cancer stage, when cancer was discovered, the disease had already advanced and was no longer amenable to first-line treatment. Regarding notification of the diagnosis, it was rarely possible to give sufficiently early notice to patients in the untreated group. The important role of consultation-liaison psychiatrist in treating cancer patients is suggested. Some steps are proposed for managing schizophrenia patients with cancer who are not able to give informed consent.

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Terminal Illness and Schizophrenia

Cited by 10 publications

References 14 publications

On the Margins of Death: A Scoping Review on Palliative Care and Schizophrenia

On the Margins of Death: A Scoping Review on Palliative Care and Schizophrenia

A Research Study Review of Effectiveness of Treatments for Psychiatric Conditions Common to End-Stage Cancer Patients: Needs Assessment for Future Research and an Impassioned Plea - A Commentary and Controversy

Factors disturbing treatment for cancer in patients with schizophrenia

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