Brief psychotic disorder associated with bereavement in a patient with terminal-stage uterine cervical cancer: a case report and review of the literature.
We report here a terminally ill patient with uterine cervical cancer who developed a brief psychotic disorder after bereavement following the loss of three close friends also suffering from gynecological cancer. A 49-year-old housewife, who was diagnosed as having uterine cervical cancer and was receiving palliative care was referred for psychiatric consultation because of an abrupt onset of delusions, bizarre behavior, disorganized speech, and catatonic behavior. On psychiatric examination, she showed delusional thought and catatonic behavior. Laboratory data were unremarkable, as was brain MRI. She had no history of psychiatric illness or drug or alcohol abuse. After receiving haloperidol, psychiatric symptoms disappeared, and she returned to the previous level of functioning after 3 days. The patient explained that the death of three of her friend due to gynecological cancer was shocking event for her. She focused her attention on her own fears of dying from the same disease. Brief psychotic disorder in cancer patients is rare in the literature. However, our report of brief psychotic disorder associated with bereavement may highlight possible precipitating factors, which have not been adequately emphasized in the literature to date. From a clinical perspective, it would be informative for liaison psychiatrists to inquire about the patient's experience of loss of significant others with the same disease. This may provide useful information helpful to understanding the patient's conception of the disease process. Cancer patients' bereaving friends who had cancer is not rare in clinical settings. Therefore, medical staff should be mindful of interpersonal relationships between patients and bereavement arising from these relationships.
Onishi
Hideki
H
Department of Psychiatry, Kanagawa Pref. Cancer Center, 1-1-2 Nakao, Asahi-ku, 241-0815, Yokohama, Japan. h-onishi@jg7.so-net.ne.jp
Onose
Masanari
M
Yamada
Tomoki
T
Mizuno
Yasuhiro
Y
Ito
Mizuho
M
Sugiura
Ken
K
Kato
Hisamori
H
Nakayama
Hiroki
H
D001601:Bereavement; D005239:Fear; D005260:Female; D006801:Humans; D008875:Middle Aged; D010166:Palliative Care; D011618:Psychotic Disorders / Q000209:etiology* / Q000523:psychology*; D019452:Terminally Ill / Q000523:psychology*; D014594:Uterine Neoplasms / Q000523:psychology*