Résumé
A psychiatric evaluation of 75 cases of different types of cancer revealed significant psychological morbidity in 81% of cases. The time lag, if any, between primary diagnosis and presentation to oncologists was noted and the reasons for the delay were ascertained. 62% of patients (N = 47) delayed three months or more and this group also showed significantly greater (p < 0.05) psychological morbidity compared to those who delayed less than three months (N = 28). 89% of patients used denial as a mental defence mechanism and there was no significant difference in the degree of denial displayed by both groups. Psychological reasons such as denial of the illness, fear of cancer, fear of its treatment, and domestic difficulty were commonly cited as causes of delay. It is hoped that addressing these issues will reduce delay and help early detection in cancer programmes.
Sujets)
Humains , Tumeurs/psychologie , Psychiatrie , Orientation vers un spécialiste , Facteurs tempsRésumé
We evaluated the psychiatric status of referred cancer patients (N = 39) and referred medical patients at two other institutions (N = 64, N = 62). Depression, anxiety, psychosis, delirium occurred with comparable frequency in both groups. Cancer patients presented with somatic complaints more frequently. However the average number of referrals of cancer patients to the psychiatric service was very low (3/months) compared to referral of medically ill patients (32/month, 10/month). The data suggests that a comparable level of psychological distress exists in cancer patients, and psychiatric referral may help in its early recognition and alleviation.
Sujets)
Adolescent , Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Enfant , Enfant d'âge préscolaire , Maladie/psychologie , Femelle , Humains , Nourrisson , Mâle , Troubles mentaux/étiologie , Adulte d'âge moyen , Tumeurs/complications , Orientation vers un spécialisteRésumé
A prospective study was undertaken to compare the patterns of psychiatric referrals in two general hospitals in Bombay viz. the King Edward Memorial Hospital (64 cases) and the Jaslok Hospital and Research Centre (62 cases). It was observed that depressive symptoms were the most common presenting symptoms in these patients attending either of the hospitals. Similarly, the commonest diagnoses were depression and organic mental disorder. Attempted suicide with organophosphorous compounds was the commonest reason for hospitalization at K.E.M. Hospital (p less than 0.001). A significant number of these patients were females (p less than 0.05). The psychiatric referrals at Jaslok had been hospitalized mainly for suspected medical or neurological illness (p less than 0.001). These patients belonged to higher economic strata and hence had a better paying capacity compared to patients at KEM hospital, a significant number of whom were unemployed (p less than 0.001). The duration of pre-referred illness of patients and their stay at Jaslok hospital were longer as compared to those at KEM Hospital (p less than 0.01). The number of non-relevant special investigations carried out on patients in Jaslok was more (p less than 0.01). Further analysis of diagnoses revealed that a significant number of patients at KEM Hospital were admitted as primary psychiatric illness (p less than 0.05).
Sujets)
Troubles neurocognitifs , Dépression , Hôpitaux généraux , Humains , Inde , Orientation vers un spécialisteRésumé
Twenty-nine acute schizophrenic patients were treated under double-blind conditions for six weeks with either centbutindole in a dose range of 3 mg/day to 4.5 mg/day or trifluoperazine in the dose range of 15 mg/day to 22.5 mg/day. Both drugs produced a significant improvement in initial psychopathology. No significant differences were demonstrated between the two treatment conditions.