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Thomas Flaig, MD

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The Intersection of Self-Harm, Psychiatric Disorders, and Cancer Diagnoses

By: Kayci Reyer
Posted: Wednesday, July 6, 2022

Research presented in Nature Medicine describes the risk of self-harm and unnatural death among patients with cancer who have also received a psychiatric disorder diagnosis. The cumulative burdens of respective psychiatric disorders were evaluated across 26 types of cancer, including bladder cancer.

“Patients with preexisting mental health conditions may be prone to relapse during their cancer journey, whereas individuals without a history of mental health may face competing demands from their cancer that could distract physicians from recognizing and diagnosing psychiatric disorders,” noted Chang and Lee, of the Institute of Health Informatics, University College London.

The study included 459,542 adults who had been diagnosed with a site-specific cancer between 1998 and 2020. Across the 26 cancer types represented, the cumulative burden of depression, anxiety disorders, schizophrenia, personality disorders, and bipolar disorders were found to occur in that order. Specifically, per 100 individuals aged 60 or older who were diagnosed with bladder cancer, the cumulative burden of depression was 4.28. Testicular cancer and chemotherapy, radiotherapy, and surgery were the cancer type and treatment modalities with the highest cumulative burden of psychiatric disorders, respectively. Of note, patients who received alkylating agent chemotherapeutics had the highest incidence of psychiatric disorders versus those treated with kinase inhibitors, who had the lowest.

Self-harm was associated with all psychiatric disorders, especially within 12 months of diagnosis of mental illness. Compared with controls, patients who experienced self-harm were 6.8 times more likely to experience an unnatural death within 12 months of the occurrence of self-harm. Notably, the risk of unnatural death decreased significantly after 12 months.

“Psychiatric disorders are treatable and modifiable risk factors, and efforts to recognize, diagnose and treat these conditions could positively affect the quality of life after cancer,” stated the authors.

Disclosure: For full disclosures of the study authors, visit nature.com.


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