Department of Psycho-Oncology
Ken Shimizu, Rika Nakahara, Yoshio Oshima, Masashi Kato, Saho Wada, Chikako Dotani, Hironobu Inoguchi, Saran Yoshida, Mariko Kobayashi, Chisato Kobayashi, Mae Endo
The Department of Psycho-Oncology was reestablished in September 1995, together with the establishment of the Psycho-Oncology Division, the National Cancer Center Research Institute East (reorganized to the Division of Psycho-Oncology, Research Center for Innovative Oncology in 2005). One of the most important clinical activities of the department is the management of cancer patients' behavioral and social problems as well as their psychological distress. Furthermore, this Division's aim is to alleviate the distress of patients, patients' families and our staff. Research activity is focused on studying the psychosocial influence of cancer on the quality of life of patients, their families, and oncology staff.
The Department of Psycho-Oncology consists of four full-time staff psychiatrists, three fulltime staff psychotherapists and three part-time psychotherapists. The Department provides two major services; a clinic for outpatients (five days a week) and consultation for referred inpatients. The purpose of the psychiatric consultation is to diagnose and treat the mental distress and cancerrelated psychological problems of patients who have been referred by their attending physicians. Since 1999, the department has played an active role as a member of the palliative care team. There is a palliative care team meeting with other members of the team every Tuesday. Additionally, a multicenter joint clinical teleconference to discuss difficult cases is held biweekly on Thursday evenings with staff members from six cancer center hospitals and four university hospitals.
In 2015, a total of 1,032 patients were referred for psychiatric consultation (Table 1). The mean age was 52.3 years old and 21.8% percent of the referrals were outpatients. A total of 463 (44.9%) of all the referred patients were males (Table 1). The most common cancer referrals were patients with hematological and breast cancer (11.4%), followed by sarcoma (10.7%), colorectal cancer (10.2%), and lung cancer (9.4%). The most common psychiatric diagnosis that is based on the DSM-IV criteria (Diagnostic and Statistical Manual of Mental Disorders, 4th edition) was adjustment disorders (25.5%), followed by delirium (20.9%), and major depressive disorder (11.1%), while 20.9% of the referrals had no psychiatric diagnosis. The three common mental disorders (delirium, adjustment disorders, and major depressive disorder) were responsible for half of the psychological problems.
We are now developing the psychosocial intervention for allogenic hematopoietic stem cell transplant survivors, the purpose of which is to improve the quality of life. This year, we have planned an observational study to decide the intervention components.
We also explored the contents of "posttraumatic growth" in Japanese cancer patients. Post-traumatic growth is a positive dimension of patients' psychological change in the aftermath of trauma. Little is known about the process in Japanese cancer patients, and this result will provide precious information to develop interventions to support patients' psychological adaptation after cancer diagnosis.
List of papers published in 2015
- Wada S, Shimizu K, Inoguchi H, Shimoda H, Yoshiuchi K, Akechi T, Uchida M, Ogawa A, Fujisawa D, Inoue S, Uchitomi Y, Matsushima E. The Association Between Depressive Symptoms and Age in Cancer Patients: A Multicenter Cross-Sectional Study. J Pain Symptom Manage, 50:768-777, 2015
- Shimizu K, Nakaya N, Saito-Nakaya K, Akechi T, Ogawa A, Fujisawa D, Sone T, Yoshiuchi K, Goto K, Iwasaki M, Tsugane S, Uchitomi Y. Personality traits and coping styles explain anxiety in lung cancer patients to a greater extent than other factors. Jpn J Clin Oncol, 45:456-463, 2015