Department of Psycho-Oncology

Ken Shimizu, Rika Nakahara, Takatoshi Hirayama, Masashi Kato, Yosuke Uchitomi, Yutaka Matsuoka, Saho Wada, Chikako Dotani, Hironobu Inoguchi, Mariko Kobayashi, Chisato Kobayashi, Mae Endo

Introduction

The Department of Psycho-Oncology was reestablished in September 1995, together with the establishment of the Psycho-Oncology Division, the National Cancer Center Research Institute East (reorganized to the Division of Psycho-Oncology, Research Center for Innovative Oncology in 2005). One of the most important clinical activities of the department is the management of cancer patients'behavioral and social problems as well as their psychological distress. Furthermore, this division's aim is to alleviate distress of patients, patients'families, and our staff. Research activity is focused on studying the psychosocial influence of cancer on the quality of life of patients, their families, and oncology staff.

Our team and what we do

The Department of Psycho-Oncology consists of six full-time staff psychiatrists, one part-time psychiatrist, two full-time staff psychotherapists, and three part-time psychotherapists. Our department provides two major services; a clinic for outpatients (five days a week) and consultation for referred inpatients. The purpose of the psychiatric consultation is to diagnose and treat mental distress and cancer related psychological problems of patients who have been referred by their attending physicians. Since 1999, our department has played an active role as a member of the palliative care team. There is a palliative care team meeting with other members of the team every Tuesday. Additionally, a multicenter joint clinical teleconference to discuss difficult cases is held biweekly on Thursday evenings with staff members from six cancer center hospitals, and four university hospitals.

In 2016, a total of 1,251 patients were referred for psychiatric consultation (Table 1). The mean age was 51.9 years old and 20.9% percent of the referrals were outpatients. Five-hundred and sixty nine (45.5%) of the whole referred patients were males (Table 1). The most common cancer referrals were patients with hematological cancer (12.4%), followed by lung cancer (9.4%), breast cancer (9.3%), and so on. The most common psychiatric diagnosis which is based on the DSM-IV criteria (Diagnostic and Statistical Manual of Mental Disorders, 5th edition) was delirium (23.3%), followed by adjustment disorders (20.3%), major depressive disorder (4.8%), and so on, while 26.6% of the referrals had no psychiatric diagnosis. The three common mental disorders (delirium, adjustment disorders, and major depressive disorder) were responsible for half of the psychological problems.

Research activities

We are now developing the psychosocial intervention for allogenic hematopoietic stem cell transplant survivors, the purpose of which is to improve the quality of life. In 2016, we planned an observational study to decide the intervention components.

We also explored the contents of "posttraumatic growth" in Japanese cancer patients. Posttraumatic Growth is a positive dimension of patients'psychological change aftermath of trauma. Little is known about the process in Japanese cancer patients, and this result will provide precious information to develop interventions to support patients'psychological adaptation after cancer diagnosis.

Table 1. Psychiatric Consultation Data in 2016 (n=1,251)