Demographic factors, referral patterns and clinical correlates in Adjustment Disorder in cancer patient referrals to an in-house liaison psychiatry service in a tertiary care oncology hospital in India — ASN Events

Demographic factors, referral patterns and clinical correlates in Adjustment Disorder in cancer patient referrals to an in-house liaison psychiatry service in a tertiary care oncology hospital in India (#422)

Jayita Deodhar 1 , Savita Goswami 1 , Lekhika Sonkusare 1 , Rohini Havaldar 1
  1. Tata Memorial Hospital, Mumbai, Mah, India

Literature on Adjustment Disorder, the most common psychiatric diagnosis in cancer patients, is scarce in the context of developing countries. Our study aims to examine the demographic, referral and clinical correlates in Adjustment Disorder in cancer patient referrals to an in-house liaison psychiatry service in a tertiary care oncology hospital in India. From an original database of demographic and clinical details of all new cancer patient referrals to the liaison psychiatry service of an oncology hospital over a 58 month period, the details of those diagnosed with Adjustment Disorder were examined to record the demographic variables, cancer diagnosis, referral patterns, psychiatric interventions used and group differences (gender and patient setting). Relevant statistical analysis using Statistical Package for Social Sciences version 18 was done for descriptive statistics and group comparisons. 451 of 2068 new patient referrals (21.8%) were diagnosed with Adjustment Disorder, in 59% inpatients and 53% males. The average age was 40.1 years. Haematolymphoid (21.1%) and head and neck cancers (18.6%) were most frequent cancer diagnoses, with referral reasons mainly for depression, sleep disturbances and anxiety. 92% of patients required psychological interventions only. Anxiolytics were the main psychopharmacological agents used. Adjustment Disorder was more common in men than women with haematolymphoid (66% vs 34%) and head and neck cancers (70% vs 30%), and more common in outpatients with head and neck and inpatients with haematolymphoid malignancies. These differences was statistically significant (p <0.000). Adjustment Disorder was the psychiatric diagnosis in more than one-fifth of cancer patients referred to an in-house liaison psychiatry service in a tertiary care cancer centre in India, seen almost equally in men and women, with a difference noted in the cancer diagnosis of male and female patients. The role of cultural influences in development of Adjustment Disorder in different groups of cancer patients needs further studies in developing countries.