Mental Health Watch

MARCH 01, 2009

Cancer Patients Need More Mental Health Care

A new study found that not enough patients with advanced cancer are referred by their oncologist for specialized psychological care, even if they demonstrate signs of distress, according to a study reported online December 28, 2008, in the Journal of Clinical Oncology.

Of the 326 patients receiving treatment in a comprehensive center for advanced lung or gastrointestinal cancer, only one third were referred for psychosocial care to a social worker, psychologist, or psychiatrist. The researchers also found a significant age difference in referral rates. All of the patients younger than 40 years of age were referred for psychosocial care, compared with 22% of patients aged 70 and older.

Researcher Gary Rodin, MD, concluded, "These findings draw attention to the need for routine screening for distress in cancer patients, for the institution of more routine mechanisms that integrate psychosocial care in cancer treatment settings, and for further research to elucidate the potential barriers to psychosocial care in older cancer patients."

Psychiatric Disorders a Risk for Premature Infants

Children born prematurely have some risk of developing anxiety, depression, or other psychiatric disorder in adolescence and young adulthood, found a study in the January 2009 issue of Pediatrics. The investigators recommend that children born preterm be monitored more closely for these disorders.

The Swedish population-wide study involved 545,628 residents born in the 1970s and followed up until 23 to 29 years of age. The researchers noticed a stepwise increase in psychiatric hospital admissions with an increasing degree of preterm birth.

The study findings indicated that 3.5% of the participants born moderately preterm at 29 to 32 weeks of pregnancy and 5.2% born very preterm at 24 to 28 weeks of pregnancy had been hospitalized due to a psychiatric disorder. The risk for psychiatric disorders was 68% greater in the very preterm group and 21% higher in the moderately preterm group, compared with participants born at 40 weeks. Based on the findings, the researchers concluded that adolescent and young adults who are born prematurely are a group "in need of more attention in research and secondary prevention" of psychiatric morbidity.

Anxiety, Depression Prevalent in Infertile Couples

Couples dealing with infertility may benefit from routine mental health screening, according to a small study. Whereas most of the 81 infertile couples involved in the study did not have the psychiatric conditions the researchers assessed, they did have higher rates of certain disorders when compared with 70 fertile couples. The investigators found that the most significant difference was in the diagnosis of adjustment disorder, especially among women. Adjustment disorder refers to symptoms of depression and anxiety in response to an identifiable cause.

The study showed that 28% of infertile women had an adjustment disorder observed by depression and anxiety, compared with 3% of fertile women. Furthermore, 18% of infertile women had a binge-eating disorder, whereas no indication was seen in the fertile women. As for the men, the evidence suggested that infertility patients had higher rates of subclinical obsessive? compulsive disorder and social phobia—indicating that the signs and symptoms of these anxiety disorders were present, but not significant enough for a diagnosis.

Physical Activity Can Improve Serious Mental Illness

Low levels of physical activity can improve the mood of individuals with serious mental illness (SMI). The study reinforces earlier studies that patients with SMI exhibit low levels of physical activity and supports the consideration of physical activity as a routine part of psychiatric rehabilitation.

The study included 11 patients from the United States and 12 patients from Serbia. In this study, physical activity included most forms of sustained movement, such as gardening, walking, or formal exercise. For 7 consecutive days, the researchers randomly paged study participants, who filled out questionnaires about their moods and recent activities. The responses were matched with data collected during the previous 10 minutes using small lightweight accelerometers worn by the participants. The equipment measured levels of activity and duration. The findings were recently reported in the International Journal of Social Psychiatry.

F A S T   F A C T: An estimated 26.2% of Americans aged 18 and older—about 1 in 4 adults—suffer from a diagnosable mental disorder in a given year.