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Cancer mortality among psychiatric patients treated in a community-based system of care: a 25-year case register study

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Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Purpose

Cancer mortality data allow assessing, at the same time, the risk of developing the disease and the quality of care provided to patients after the oncologic diagnosis. This study explores the risk of death caused by a single tumor site in a psychiatric population treated in a community-based psychiatric service.

Methods

All patients with an ICD-10 psychiatric diagnosis, seeking care in 1982–2006 (25 years), were included. Data were drawn from the South Verona Psychiatric Case Register (PCR). Mortality and cause of death were ascertained using different procedures and sources. Standardized mortality ratios (SMRs) were used to compare the observed number of deaths with the expected number using as reference a population in the Veneto region.

Results

Having been admitted to the hospital (SMR = 1.32), having a short interval from registration (1.52), having a diagnosis of alcoholism (2.03), and being a middle-aged male (1.83) were factors showing an increased risk of death from cancer. Increased SMRs were found for cancer of the oral cavity (22.93), lymphoma, leukemias, Hodgkin's lymphoma (8.01), and central nervous system (CNS) and cranial nerve tumors (4.75). The SMR decreased for stomach tumors (0.49). Patients with alcoholism (5.90 for larynx), affective disorders (20.00 for lymphomas), and personality disorders (28.00 for SNC) were found to be exposed to a high risk of cancer death in specific sites.

Conclusions

Psychiatric patients showed different patterns of site-specific cancer mortality when compared with the general population. The 20-fold higher risk of dying from hematological neoplasms needs further investigation. Chronic use of phenothiazines could be involved in the relative protection from stomach and prostate cancer found in psychiatric patients.

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Acknowledgments

This work was supported by Fondazione Cassa di Risparmio di Verona Vicenza Belluno e Ancona, Biomedical Research Projects 2003, grant “Mortality for neoplasm among psychiatric patients and general population”.

We thank the South-Verona PCR data managers, Cristina Pighi and Giuliano Meneghelli, for their help in data collection.

This paper was presented at the IXth International Conference of the European Network for Mental Health Service Evaluation(ENMESH), Ulm, Germany, 23–25 June 2011.

Conflict of interest

None for any of the authors.

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Authors and Affiliations

  1. Section of Psychiatry and Section of Clinical Psychology, Department of Public Health and Community Medicine, Policlinico GB Rossi, University of Verona, P.le L.A. Scuro 10, 37134, Verona, Italy

    Giovanni Perini, Laura Grigoletti, Batul Hanife, Michele Tansella & Francesco Amaddeo

  2. DISIA Department of Statistics, Informatics and Applicatins “G. Parenti”, University of Florence, Florence, Italy

    Annibale Biggeri

Authors
  1. Giovanni Perini
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  2. Laura Grigoletti
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  3. Batul Hanife
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  4. Annibale Biggeri
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  5. Michele Tansella
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  6. Francesco Amaddeo
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Correspondence to Laura Grigoletti.

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Perini, G., Grigoletti, L., Hanife, B. et al. Cancer mortality among psychiatric patients treated in a community-based system of care: a 25-year case register study. Soc Psychiatry Psychiatr Epidemiol 49, 693–701 (2014). https://doi.org/10.1007/s00127-013-0765-0

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  • DOI: https://doi.org/10.1007/s00127-013-0765-0

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