Cancer diagnosis in people with severe mental illness: practical and ethical issues.
Cancer diagnosis in people with severe mental illness: practical and ethical issues.
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DOI：
10.1016/s1470-2045(10)70085-1
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发表时间：
2010-08-01
期刊：
影响因子：
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通讯作者：
Thornicroft, Graham
中科院分区：
文献类型：
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作者：
Howard, Louise M;Barley, Elizabeth A;Thornicroft, Graham
人们越来越认识到严重精神疾病患者的高身体发病率，但很少有关于这些患者癌症的报道。因此，我们回顾了已发表的关于严重精神疾病患者癌症风险、治疗挑战和伦理问题的研究。严重精神疾病与使个人易患某些癌症（包括肺癌和乳腺癌）的风险增加的行为有关，尽管据报告这一人群患其他癌症的比率较低。严重精神疾病还与癌症筛查的差异和较高的病死率有关。这一较高的发生率部分是由于治疗这些患者的具体挑战，包括医学合并症、药物相互作用、能力不足以及由于精神症状而难以应对治疗方案。为确保严重精神疾病患者得到有效治疗，所有相关的保健专业人员，包括精神卫生服务和外科及肿瘤团队的专业人员，都需要解决护理方面的不平等问题。
There has been increasing recognition of the high physical morbidity in patients with severe mental illness, but little has been written about cancer in these patients. Therefore, we review the published work on risk of cancer in patients with severe mental illness, treatment challenges, and ethical issues. Severe mental illness is associated with behaviours that predispose an individual to an increased risk of some cancers, including lung and breast cancer, although lower rates of other cancers are reported in this population. Severe mental illness is also associated with disparities in screening for cancer and with higher case-fatality rates. This higher rate is partly due to the specific challenges of treating these patients, including medical comorbidity, drug interactions, lack of capacity, and difficulties in coping with the treatment regimen as a result of psychiatric symptoms. To ensure that patients with severe mental illness receive effective treatment, inequalities in care need to be addressed by all health-care professionals involved, including those from mental health services and the surgical and oncology teams.