Psychiatric psychotherapeutic interventions in breast cancer inpatients: a contribution to liaison-consultation psychiatry

• Published in: Nervenarzt 2014-11, Vol.85 (11), p.1390-1401
• Main Authors: Grube, M, Weigand-Tomiuk, H
• Format: Article
• Language: ger
• Subjects: Adult; Aged; Aged, 80 and over; Breast Neoplasms - epidemiology; Breast Neoplasms - psychology; Breast Neoplasms - therapy; Female; Germany - epidemiology; Hospitalization - statistics & numerical data; Humans; Mental Disorders - epidemiology; Mental Disorders - psychology; Mental Disorders - therapy; Middle Aged; Prevalence; Psychotherapy - statistics & numerical data; Quality of Life - psychology; Referral and Consultation - statistics & numerical data; Risk Factors; Treatment Outcome
• ISSN: 1433-0407
• DOI: 10.1007/s00115-013-3940-3

Psychosocial stress and psychopathological abnormalities are expected in cancer patients at a frequency of 30-60%. Apart from decreased quality of life psychological factors may cause a negative impact on treatment compliance and on the subsequent biological course of tumor development. This study examined the association of different psychiatric and psychotherapeutic interventions in liaison-consultation psychiatry with the four psychopathological dimensions derived by factor analysis based on the items of psycho-oncological basic documentation in a group of 141 breast cancer patients without pre-existing mental disorders who were inpatients of a gynecologic cancer centre. In addition information concerning subjective stress experience was collected with the distress thermometer. The plausible fit of the various psychiatric and psychotherapeutic interventions due to the psychopathological dimensions and due to the subjective experience of stress could be demonstrated. Those intervention variables that were associated with an improvement of the psychological state could be described as well. The findings showed that improvement or at least stability of the psychological state was regularly associated with completion of oncological treatment in the relevant index inpatient stay. In addition it was found that the interventions offered could contribute to improved psychological well-being in the subgroup of patients without mental disorders particularly in normal grief reactions. Despite methodological limitations this investigation contributes to describing relevant psychopathological syndromes in a group of breast cancer patients without pre-existing mental disorders and the goodness of fit of the different psychiatric and psychotherapeutic interventions. Finally the study confirmed the assumption that stabilization of the mental state may help to avoid treatment interruptions in an oncological inpatient setting and therefore decrease the likelihood that reduced psychological well-being can negatively impact the biological course of tumor development.