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Psychiatric disorders delay cancer diagnosis
August 15, 2005Patients with psychiatric disorders are diagnosed with esophageal cancer much later and at a more advanced stage than patients with no psychiatric diagnosis, according to a study conducted by researchers in the Oregon Health & Science University Digestive Health Center. The finding is significant, according to the study's principal investigator, Blair Jobe, M.D., because life and death for cancer patients is all about early detection and intervention.
This study was prompted by observations made in Jobe's clinical practice. He and colleagues wished to determine whether psychiatric illness represented an independent risk factor for delay in diagnosis and advanced disease at the time the patient first displayed symptoms.
"Research has shown that initial diagnosis and management of a disease process is more difficult in patients with a psychiatric disorder," explained Jobe, an assistant professor of surgery in the OHSU School of Medicine, Portland Veterans Affairs Medical Center (PVAMC). "Although a delay in diagnosis of esophageal cancer did not appear to result in a reduction of overall survival - a reflection of the lethality of esophageal cancer - the relationship between psychiatric disorders and esophageal cancer is very important to heed, especially as we improve in our ability to make the diagnosis in the early, more curable stages."
In this study, Jobe and colleagues reviewed the medical records of 160 veterans with esophageal cancer seen at the PVAMC during a 13-year period. Fifty-two of the veterans had been diagnosed with a psychiatric disorder prior to their cancer diagnosis; the remaining 108 patients had no psychiatric disorder prior to diagnosis. Psychiatric disorders reported include depression, dementia, anxiety, schizophrenia, personality disorder and post-traumatic stress disorder.
The researchers found that no single risk factor contributed to a delay in diagnosis. Rather, they suggest that one or more variables may play a role, including provider bias or lack of awareness, patients' inability to articulate symptoms, patients' socio-economic status or their lack of access to care. Research to determine exactly which of these variables play a role and how to best rectify them is ongoing at OHSU.
"From here it will be important to understand why patients with psychiatric illness have a delay and eliminate it," said Jobe, also a member of the OHSU Cancer Institute. "In the meantime, our findings emphasize the importance of prompt evaluation of symptoms in all patient populations."
Oregon Health & Science University
In this study, Jobe and colleagues reviewed the medical records of 160 veterans with esophageal cancer seen at the PVAMC during a 13-year period. Fifty-two of the veterans had been diagnosed with a psychiatric disorder prior to their cancer diagnosis; the remaining 108 patients had no psychiatric disorder prior to diagnosis. Psychiatric disorders reported include depression, dementia, anxiety, schizophrenia, personality disorder and post-traumatic stress disorder.
The researchers found that no single risk factor contributed to a delay in diagnosis. Rather, they suggest that one or more variables may play a role, including provider bias or lack of awareness, patients' inability to articulate symptoms, patients' socio-economic status or their lack of access to care. Research to determine exactly which of these variables play a role and how to best rectify them is ongoing at OHSU.
"From here it will be important to understand why patients with psychiatric illness have a delay and eliminate it," said Jobe, also a member of the OHSU Cancer Institute. "In the meantime, our findings emphasize the importance of prompt evaluation of symptoms in all patient populations."
Oregon Health & Science University
Psychiatric Disorders Current Events and Psychiatric Disorders News RSSNearly 5 percent of the US population suffers from persistent depression or anxiety
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Stress-related disorders affect brain's processing of memory
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Lower childhood IQ associated with higher risk of adult mental disorders
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Ultrasound shown to exert remote control of brain circuits
In a twist on nontraditional uses of ultrasound, a group of neuroscientists at Arizona State University has developed pulsed ultrasound techniques that can remotely stimulate brain circuit activity.
MSU doctors bring much-needed psychiatric care to rural areas via technology
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Mouse genes guide search for human anxiety disorder genes
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Study finds genomic changes in the brains of people who commit suicide
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Insomnia in women with breast cancer linked to heart rate dysregulation
A study in the October 15 issue of the Journal of Clinical Sleep Medicine shows that respiratory sinus arrhythmia (RSA) is a significant predictor of insomnia in women with breast cancer and confirmed that longer nocturnal wake episodes were associated with a flatter diurnal cortisol slope.
New research on family-based HIV prevention presented at annual NIH conference
Researchers from the Bradley Hasbro Children's Research Center (BHCRC) presented exciting new research today at the National Institute of Mental Health (NIMH) Annual International Research Conference on the Role of Families in Preventing and Adapting to HIV/AIDS.
Monitoring outcomes of suicide attempts in pregnancy can better assess drug dangers
Monitoring the health of children born to women who attempted suicide while pregnant can shed light on which medicines and what doses are particularly dangerous to developing fetuses, according to researchers from Hungary who publish their findings in a series of reports in a special issue of Toxicology and Industrial Health, published this week by SAGE.
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