Prevalence of psychological morbidity in terminally-ill cancer patients

The aim of this study was to obtain objective data on the type and frequency of psychological and psychiatric problems in terminally ill patients and determine the influence of various factors on prevalence of adjustment disorder (ie., sociodemographics, awareness of the diagnosis, clinical variables, performance status, degree of pain). Between 1990–1993 410 patients attending Gdańsk Hospice were examined. The following results were obtained; 40% showed a normal response to cancer, and, of the remaining 60%, 37% showed psychological morbidity connected with the carcinoma. Better adaptation to the disease was observed in elderly patients who were usually unaware of their medical status. In the group with an organic mental syndrome most were in the final stage of their terminal illness. Adaptation disorders appeared mostly in younger women under 60 years of age, the more highly educated, those with breast cancer and those who were aware of the medical situation. It was noted that such patients made more complaints of severe pain and tended to be less tolerant of pain. This group therefore requires the most intensive emotional support, counselling or psychotherapy.