Common psychiatric problems in older patients with cancer: Report of one-year experience of a psychiatry outpatient clinic

ObjectiveCancer is a leading cause of morbidity and mortality in the aging population. Despite progress in our knowledge of cancer in older people, there remains a scarcity of systematically studied data on the psychosocial impact of cancer in the elderly. The aim of this study is to examine the distribution of psychiatric diagnoses and treatment in cancer patients 65 and older referred to a tertiary care cancer center psychiatry clinic.Materials and MethodsWe undertook a chart review of the new referrals, age 65 and older, treated at Memorial Sloan Kettering Cancer Center (MSKCC) psychiatry outpatient clinic between July 1st 2005 and June 30th 2006.ResultsOf the 239 patients referred to the clinic during the one-year period 86% were referred by their oncologists and, only 8.8% were self-referred. The most common reason for referral was depressive symptoms (54.4%), followed by difficulty coping (18%), and anxiety (15.1%). Main psychiatric diagnoses were as follows: 20.1% mood disorder due to general medical condition (GMC), 11.7% major depressive disorder, and 8.4% anxiety disorders. 6.7% of patients were diagnosed with a cognitive disorder after the first consultation. Only 40% of patients with a depressive disorder diagnosis had a prior history of depression. 56% of patients had no known past psychiatric history prior to cancer diagnosis.ConclusionPsychiatric disorders in elderly cancer patients are varied, and require recognition and ongoing management by health care professionals.