gms | German Medical Science

Background: Probable courses of mental stress and psychiatric disorders in cancer patients may be employed as predictors on individual cases. This information can help to prepare better psychooncological support.

Methods: Between 2002 and 2003 cancer patients in primary treatment (t1:n=689) of four Leipzig clinics were interviewed using Standardized Clinical Interview for DSM IV by trained interviewers. Investigated diagnoses covered affective, anxiety, stress and addiction disorders. Data on interventions and medical course were collected. The follow-up (t2:n=100) took place after 11–18 months. An ongoing second follow-up is scheduled 30–42 months after baseline.

Results: At baseline 40% of the tumour patients showed a mental disorder (11% stress disorders, 17% affective disorders, 20% anxiety disorders, 10% addiction disorders). While the overall quota of psychiatric diagnoses at follow-up did not change significantly (41%), interesting changes in the frequency of certain diagnoses were found: acute stress reactions and adjustment disorders decreased remarkably (3%), the frequency of anxiety disorders (PTSD, generalised anxiety disorder, panic disorder) raised (28%). The frequency of affective disorders did not change (17%), but its patterns: MDE decreased, Dysthymia increased (table). The rate of persisting mental disorders between t1 and t2 ranged from 0% (acute stress reaction, social phobia, panic disorder) to 80% (PTSD).

Conclusion: The frequency of mental disorders in cancer patients remains significantly increased in the long run. Especially PTSD, generalised anxiety disorder and panic disorder should be focused on, as these tend to persist or emerge.

Table 1 [Tab. 1]