精神科身体疾患合併症病棟に入院したがんを合併する精神疾患患者に関する検討

Examination of Mental Disease Patients Complications with Cancer admitted to the Psychiatric Ward for Those with Nonmental

抄録

　精神症状のコントロールや身体的治療目的で相模台病院精神科身体合併症病棟へ入院したがん患者50例の臨床的特徴に関して後方視的な調査を行った。

　がんの臓器別分類では消化器・肝胆膵のがんが多かったこと，入院後にがんの診断がついた患者が全体の約4割近くを占め，その中には進行がんで転移や他臓器などへの浸潤から手術適応がない症例がみられたこと，精神症状のためにがんの告知や本人の理解や同意を得るのが難しいケースもあり，工夫が必要な症例が存在したこと，転帰では死亡が36％存在していたこと，などが明らかになった。これらの結果から，精神疾患患者ががんに罹患した場合の臨床における具体的な問題点に関して考察を行った。

　A retrospective study was carried out on the clinical characteristics of 50 psychiatric patients with cancer complications who were admitted to the Psychiatry Ward of Sagamidai Hospital, which also treats patients with nonmental disease complications, for the treatment of their psychiatric symptoms and nonmental diseases. The following findings were obtained：1) among these patients, many had cancers particularly in digestive organs, such as the liver, pancreas, and other biliary organs, 2) the percentage of these patients who were diagnosed as having cancer after admission was approximately 40%, some of whom were inoperable because of the advanced stage of their cancer, i. e., the metastasis and invasion of the cancer to other organs, 3) some special measures were necessary because notifying the patients about their cancer and obtaining their understanding and consent to an operation were sometimes difficult, and 4) 36% of the patients died from cancer. On the basis of these findings, we discussed the specific clinical problems associated with psychiatric patients with cancer complications.