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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 RSSPossible Link Studied Between Childhood Abuse and Early Cellular Aging
Children who suffer physical or emotional abuse may be faced with accelerated cellular aging as adults, according to new research from Butler Hospital and Brown University.
Psychiatric impact of torture could be amplified by head injury
Depression and other emotional symptoms in survivors of torture and other traumatic experiences may be exacerbated by the effects of head injuries, according to a study from the Harvard Program in Refugee Trauma (HPRT), based in the Massachusetts General Hospital (MGH) Department of Psychiatry.
Angiochem crosses BBB, shows safety, efficacy in phase 1/2 brain cancer studies
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Are the monoamines involved in shaping conduct disorders?
Antisocial and aggressive behaviours represent a widespread and expensive social problem. Recent research has convincingly shown that there is a strong interaction between genetic inheritance and environment for development of personality and behaviour.
Common variation in gene linked to structural changes in the brain
An international group of researchers is the first to show that common variations in a gene - previously shown to be associated with Retts Syndrome, autism, and mental retardation - are associated with differences in brain structure in both healthy individuals and patients with neurological and psychiatric disorders.
Sleep patterns in children and teenagers could indicate risk for depression, researcher finds
Sleep patterns can help predict which adolescents might be at greatest risk for developing depression, a researcher at UT Southwestern Medical Center has found in a five-year study.
Sleep patterns in children and teenagers could indicate risk for depression, researcher finds
Sleep patterns can help predict which adolescents might be at greatest risk for developing depression, a researcher at UT Southwestern Medical Center has found in a five-year study.
Abnormal Brain Circuits May Prevent Movement Disorder
Most people who carry a genetic mutation for a movement disorder called dystonia will never develop symptoms, a phenomenon that has puzzled scientists since the first genetic mutation was identified in the 1990's.
New links between lucid dreaming and psychosis could revive dream therapy in psychiatry
Similarities in brain activity during lucid dreaming and psychosis suggest that dream therapy may be useful in psychiatric treatment, a European Science Foundation (ESF) workshop has found.
Mothers of children with autism have higher parental stress, psychological distress
Ask any mother and she'll tell you that raising a preschooler is no easy task. Now imagine what it must be like to bring up a child with autism or a developmental delay.
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