Mental Health Watch

Cancer Patients Need More Mental Health Care

A new study found that not enoughpatients with advanced cancer are referredby their oncologist for specializedpsychological care, even if they demonstratesigns of distress, according toa study reported online December 28,2008, in the Journal of Clinical Oncology.

Of the 326 patients receiving treatmentin a comprehensive center for advancedlung or gastrointestinal cancer, only onethird were referred for psychosocial careto a social worker, psychologist, or psychiatrist.The researchers also founda significant age difference in referralrates. All of the patients younger than 40years of age were referred for psychosocialcare, compared with 22% of patientsaged 70 and older.

Researcher Gary Rodin, MD, concluded,"These findings draw attention to theneed for routine screening for distressin cancer patients, for the institution ofmore routine mechanisms that integratepsychosocial care in cancer treatmentsettings, and for further research to elucidatethe potential barriers to psychosocialcare in older cancer patients."

Psychiatric Disordersa Risk for PrematureInfants

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

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

The study findings indicated that 3.5% of the participantsborn moderately preterm at 29 to 32 weeks of pregnancy and5.2% born very preterm at 24 to 28 weeks of pregnancy hadbeen hospitalized due to a psychiatric disorder. The risk forpsychiatric disorders was 68% greater in the very preterm groupand 21% higher in the moderately preterm group, comparedwith participants born at 40 weeks. Based on the findings, theresearchers concluded that adolescent and young adults whoare born prematurely are a group "in need of more attention inresearch and secondary prevention" of psychiatric morbidity.

Anxiety, DepressionPrevalentin InfertileCouples

Couples dealing with infertility may benefit from routinemental health screening, according to a small study. Whereasmost of the 81 infertile couples involved in the study did nothave the psychiatric conditions the researchers assessed, theydid have higher rates of certain disorders when comparedwith 70 fertile couples. The investigators found that the mostsignificant difference was in the diagnosis of adjustment disorder,especially among women. Adjustment disorder refersto symptoms of depression and anxiety in response to anidentifiable cause.

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

Physical Activity Can ImproveSerious Mental Illness

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

The study included 11 patients from the United States and12 patients from Serbia. In this study, physical activity includedmost forms of sustained movement, such as gardening, walking,or formal exercise. For 7 consecutive days, the researchersrandomly paged study participants, who filled out questionnairesabout their moods and recent activities. The responseswere matched with data collected during the previous 10 minutesusing small lightweight accelerometers worn by the participants.The equipment measured levels of activity and duration.The findings were recently reported in the International Journalof 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 adiagnosable mental disorder in a given year.