ORIGINAL ARTICLES   

Minerva Psichiatrica 2008 March;49(1):1-8

Copyright © 2008 EDIZIONI MINERVA MEDICA

language: English

Psychological distress during the last three months of life of Italian cancer patients. Results from the Italian Survey of the Dying of Cancer (ISDOC)

Beccaro M. ¹, Di Leo S. ², Morasso G. ², Costantini M. ¹ on behalf of ISDOC Study Group

¹ Regional Palliative Care Network National Cancer Research Institute, Genoa, Italy; ² Psychology Service National Cancer Research Institute, Genoa, Italy

Aim. The aim of this study was to estimate at a national level the prevalence of Italian patients deceased for cancer who experienced anxiety or depressive symptoms in the last three months of life, the kind of aid they received and its effectiveness in reducing psychological distress.
Methods. A mortality follow-back survey of 2 000 cancer deaths, representative of the whole country. Information on patients’ experience was gathered from the non-professional caregiver with an interview. A section of the interview covered information about the emotional impact of terminal illness in cancer patients.
Results. Valid interviews were obtained for 67% of the identified caregivers (N.=1 271). Most Italian cancer patients (74.4%) suffered from anxiety or depression (42.1% often or most of the time; 32.3% sometimes or rarely). The factors associated with a high prevalence of psychological distress were: low patient’s and caregiver’s age (P=0.02 for both), high period of time of non-self-sufficiency (P<0.01). Most patients received only a pharmacotherapy (24.6%), 4.5% of patients received a support from a specialist, half of them together with a pharmacotherapy. The intervention for the psychological distress relieved the symptoms much or very much only in the 27.2% of the cases. No significant correlation between psychological distress, the four scales used to evaluate the interview (r between -0.08 and -0.05), and the timing of the interview (r=0.06) was observed.
Conclusion. Easing emotional distress, treating depression and anxiety and supporting patients are essential goals in palliative care, and every health professionals has a key role in focusing, recognizing, evaluating and addressing patient’s emotional problems.