Depression and anxiety symptoms following cancer diagnosis: a cross-sectional study.

INTRODUCTION: The aims of the present study were to assess demographic and clinical characteristics of patients after receiving a cancer diagnosis, and to determine possible risk factors for anxiety and depression. METHODS: All consecutive patients aged 18 or above, were assessed before starting intravenous chemotherapy for the first time with the Hospital Anxiety and Depression Scale (HADS), the Distress Thermometer, and a Visual Analog Scale for pain. Demographic and clinical data were also collected. RESULTS: The patients assessed (n = 270) had a mean age of 59.4 (SD = 11.8) years, and 50.7% were women. Tumours were more frequently colorectal (27.2%), lung (18.8%) and breast (17.6%), and 68.9% were stages 3 or 4. A HADS Anxiety score ≥8 was present in 30% of the patients, a Depression score ≥8 in 24.1%, and a Distress score ≥4 in 44.4%. Independent risk factors for HADS Depression score ≥8 were being a woman (OR = 2.45; p = 0.004), being older (OR = 1.04; p = 0.005), and cancer stage 3-4 (OR = 2.24; p = 0.023) in the multivariable analysis; for Anxiety ≥8 they were being a woman (OR = 2.47; p = 0.002), having a past psychiatric consultation (OR = 2.83; p = 0.029), and cancer stage 3-4 (OR = 1.90; p = 0.047). CONCLUSION: These results suggest the need for greater awareness and a differentiated approach to patients at increased risk of anxiety and depression in the early stages of treatment and before starting chemotherapy.

Characteristics of frequent users of an acute psychiatric inpatient unit: a five-year study in Portugal.

OBJECTIVE: This study examined demographic and clinical characteristics of frequent users of a psychiatric inpatient unit in Portugal. METHODS: Data (2004-2008) for 1,348 consecutive psychiatric inpatients were reviewed. Frequent users (N=137), who had at least three admissions in the study period, were compared with nonfrequent users (N=1,211) on age, gender, race-ethnicity, diagnosis, and compulsory admissions. Data were analyzed with chi square and Student's t tests. RESULTS: Frequent users accounted for 29% of admissions. They were significantly younger than nonfrequent users (39±14 versus 44±17, p<.001), and a larger proportion had compulsory admissions (28% versus 14%, p<.001). The frequent user group also had significantly higher rates of bipolar disorder (61% versus 46%, p<.001) and schizophrenia (29% versus 18%, p<.003). CONCLUSIONS: Understanding characteristics of frequent users can inform development of appropriate services. Research should address other variables related to frequent admissions, including socioeconomic factors, general medical and psychiatric comorbidities, and treatment compliance.

An OCD patient presenting with a cerebellum venous variant in a family with a strong schizophrenia loading: a case report.

The role of cerebellar pathology in psychiatric symptoms has long been recognized. Cerebellar pathology has been associated with obsessive-compulsive disorder pathophysiology, particularly with compulsive hoarding. Likewise, some cerebellum abnormalities have been described in schizophrenia, as well as in comorbidity between obsessive-compulsive disorder and schizophrenia. The authors report the case of a 32-year-old woman with obsessive-compulsive disorder and a cerebellum development variant in a family with a strong schizophrenia loading. This case emphasizes the probable role of the cerebellum in the pathophysiology of both obsessive-compulsive disorder and schizophrenia, and reconsiders the existence of a so called schizo-obsessive subtype of schizophrenia.