ORIGINAL ARTICLE   

Minerva Psichiatrica 2017 June;58(2):75-84

DOI: 10.23736/S0391-1772.17.01927-6

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Psychopathology in cancer patients through highlights and inconclusive issues: outcomes of an Italian cross-sectional survey

Leonardo FEI ¹, Luca BONI ², Francesco DI COSTANZO ³, Angela SALOMONI ⁴ ✉

¹ Psycho-Oncology Unit, Careggi University Hospital, Florence, Italy; ² Clinical Trials Coordinating Center, Tuscan Tumor Institute (ITT), Florence, Italy; ³ Department of Oncology, Careggi University Hospital, Florence, Italy; ⁴ General Management, Careggi University Hospital, Florence, Italy

BACKGROUND: Cancer patients are well-known to go through psychopathological issues during the course of illness. Nevertheless, prevalence rates of psychopathology and its correlations with clinical features are not yet defined but surveys are commonly impaired by biases. The aim of our study was to investigate the prevalence of psychopathology and its correlations with clinical and therapeutic aspects.
METHODS: A cross-sectional study was conducted over a period of 24 consecutive months at a University Hospital in Italy. The protocol required the enrollment of two groups of cancer patients, the first one composed of all the subjects sent to the Psycho-Oncology Unit for a psychological evaluation and/or support and the second one of patients in charge to the Department of Oncology that agreed to be submitted to the same psycho-diagnostic assessment (Structured Clinical Interview for DSM-IV Axis I Disorders). A contingency analysis was performed.
RESULTS: A total of 744 cancer patients (first arm, N.=530; second arm, N.=214) were enrolled. The prevalence of psychiatric conditions amounted to 24.9%, whereof almost one fifth presented organic psychiatric syndromes (4.4% of the total sample), and it was very significantly correlated with the first arm of admission (χ2=224.15, P<0.001). Differently, psychopathological “sub-threshold” conditions amounted to 41.5% and trended very significantly to increase along the course of illness (χ2=23.64, P<0.001).
CONCLUSIONS: Estimating the prevalence of psychopathology is challenging owing to the remarkable importance of different ways of admission of the patients to surveys. While taking into account the features and inconclusive issues stemming from epidemiological surveys, the prevalence rate of psychiatric disorders could be considered not far from that of the general population. Conversely, the prevalence rate of “sub-threshold” conditions seems to be close to that of the psychological distress of cancer patients.

KEY WORDS: Neoplasms - Psychiatry - Prevalence