Psychiatric morbidity among adult cancer patients admitted at ocean road cancer institute, Dar es salaam, Tanzania

Abstract

The number of people diagnosed with cancer is increasing each year with 10.9 million people worldwide being diagnosed with cancer annually. Among these 54% are in developing countries. Tanzania being one of the developing countries is not exceptional to the problem Studies conducted worldwide pertaining psychiatric morbidity in cancer patients have shown significant psychiatric morbidity in these patients most of which goes undetected by the medical staff looking after these patients Many studies have been done globally pertaining psychiatric morbidity among cancer patients yet no study of this kind has been done in Tanzania in patients with cancer and hence there was a limited information regarding the situation Aim: To establish psychiatric morbidity among adult cancer patients admitted at ORCI, Dar es Salaam Tanzania Study design: A cross-sectional descriptive study among adult cancer patients admitted at ORCI who fulfilled the inclusion criteria Study area: The study was carried out at Ocean Road Cancer institute, Dar es salaam, Tanzania Study instruments: Study participants were interviewed using Mini International Neuropsychiatric Interview (M.I.N.I) and a researcher designed social demographic and clinical questionnaire Data analysis: Data was double entered, followed by cleaning and analysis using SPSS version 16 and inferential analysis. Results are presented in form of tables, charts, graphs and narratives. _RESULTS: A total of 150 male and female patients 'participated in the study. Overall prevalence of psychiatric morbidity based on the MINI criteria was 50.7% when pain disorder due to general medical condition and psychological factor was excluded as a psychiatric morbidity (i.e. pain considered as a symptom rather than a disorder) and 65.3% when pain disorder due to general medical condition and psychological factor was included as a psychiatric morbidity. The three leading types of psychiatric morbidities were pain disorder associated with psychological factors and general medical condition (40.7%) when pain considered as a disorder, suicidality (38.7%) and major depressive episodes (28.0%). Others include panic disorders (4.6 %), psychotic disorder (4 %) , antisocial personality disorder 2%, The other less frequent psychiatric morbidities were Adjustment disorder, dysthymia, (Hypo) Manic episodes, Obsessive compulsive disorder, Alcohol abuse and dependence with each of these morbidities affecting less than 1% of the patients None of these patients with the above psychiatric morbidities had the problem documented in the clinical file notes. Statistically significant associations were observed between types of mental disorders and marital status, level of education, occupation, type of treatment modality, and the presence of severe pain. Conclusion: Psychiatric morbidity is high among cancer patients and often goes undetected. This calls for special attention of health care professionals for proper psychological assessment and management.