title: Psychiatric disorders and stress factors experienced by staff members in cancer hospitals: a preliminary finding from psychiatric consultation service at National Cancer Center Hospitals in Japan.
abstract: OBJECTIVE
  The purpose of this study is to identify psychiatric disorders and stress factors experienced by staff members in cancer hospitals who were referred to psychiatric consultation service, and to investigate the association between psychiatric disorders and stress factors.
  
  
  METHODS
  A retrospective descriptive study using clinical practice data on staff members referred to psychiatric consultation service, obtained for 8 years, was conducted at two National Cancer Center Hospitals in Japan. Psychiatric disorders were identified according to DSM-IV. Stress factors were extracted from a chief complaint at the initial visit in medical charts, using a coding approach, and grouped as job stress or personal stress. The frequencies of the stress factors were determined by two coders who were unaware of the categorized procedure. Fisher's exact test was used to determine the association between psychiatric disorders and stress factors.
  
  
  RESULTS
  Of 8077 psychiatric consultations, 65 (1%) staff members were referred. The most common psychiatric disorder was adjustment disorder (n = 26, 40%), followed by major depression (n = 17, 26%). Eight stress factors were identified from 76 meaning units and were grouped into five job stresses and three personal stresses. Of the five job stresses, four were most frequently experienced in adjustment disorders, and "failure to adapt to job environmental change" was significantly associated (p = 0.014). Two of the three personal stresses were most frequently experienced in psychiatric disorders other than major depressive disorder and adjustment disorders, and "suffering from mental disease" was significantly associated (p = 0.001).
  
  
  CONCLUSIONS
  We found that very few staff members were provided with psychiatric consultation service. A comprehensive support system for job stress might be needed to prevent adjustment disorders, as those are suggested to be the most common psychiatric disorders among staff members in cancer hospitals.
authors.affiliation: Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center, Hospital East, Kashiwa, Chiba, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Asai
authors.forename: Nobuya
authors.initials: N
authors.lastname: Akizuki
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Akechi
authors.forename: Tomohito
authors.initials: T
authors.lastname: Nakano
authors.forename: Ken
authors.initials: K
authors.lastname: Shimizu
authors.forename: Shino
authors.initials: S
authors.lastname: Umezawa
authors.forename: Asao
authors.initials: A
authors.lastname: Ogawa
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Matsui
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Uchitomi
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D002173:Cancer Care Facilities; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007564:Japan; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D008875:Middle Aged; D009369:Neoplasms; D011567:Psychiatric Department, Hospital; D012017:Referral and Consultation; D012189:Retrospective Studies; D013315:Stress, Psychological / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy