title: Treatment response to psychiatric intervention and predictors of response among cancer patients with adjustment disorders.
abstract: BACKGROUND
  Although adjustment disorders (ADs) are common among patients with cancer and such patients are frequently referred to consultation-liaison psychiatrists, little is known about the clinical courses of these patients.
  
  
  OBJECTIVE
  The present study investigated treatment response to psychiatric intervention and predictors of response in a relatively large sampling of cancer patients with ADs.
  
  
  METHODS
  We created a database of all referral cases with ADs that included data on the patients' demographic and medical factors and physician-rated Clinical Global Impression (CGI) scale to assess treatment response and clinical course. A CGI-Improvement scale score of better than "much improved" was regarded as indicating a response to treatment; the number of patients who responded to treatment during a four-week follow-up period was assessed. Also, predictors of treatment response were explored by examining demographic and medical factors using a multivariate analysis.
  
  
  RESULTS
  Among the 238 eligible patients, 136 (57.1%) responded to psychiatric treatment; most of these responders improved to a subthreshold level of illness. On the other hand, 56 patients (23.5%) did not respond to psychiatric treatment, seven patients (2.9%) developed major depressive disorders, and 39 patients (16.4%) discontinued treatment before achieving a response. Among the predictive factors that were explored, suffering from pain significantly predicted a good treatment response, whereas a worse performance status predicted a poor treatment response.
  
  
  CONCLUSIONS
  Cancer patients with ADs can respond to psychiatric treatment, but a few cases develop major depressive disorders. Several predictors of treatment response were identified.
authors.affiliation: Psycho-Oncology Division, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan. keshimiz@ncc.go.jp
authors.forename: Ken
authors.initials: K
authors.lastname: Shimizu
authors.forename: Nobuya
authors.initials: N
authors.lastname: Akizuki
authors.forename: Naoki
authors.initials: N
authors.lastname: Nakaya
authors.forename: Maiko
authors.initials: M
authors.lastname: Fujimori
authors.forename: Daisuke
authors.initials: D
authors.lastname: Fujisawa
authors.forename: Asao
authors.initials: A
authors.lastname: Ogawa
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Uchitomi
mesh_terms: D000275:Adjustment Disorders / Q000209:etiology / Q000523:psychology* / Q000628:therapy*; D000368:Aged; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000523:psychology*; D011237:Predictive Value of Tests; D011570:Psychiatry; D011613:Psychotherapy; D011619:Psychotropic Drugs / Q000009:adverse effects / Q000627:therapeutic use; D012017:Referral and Consultation; D012959:Socioeconomic Factors
chemical_list: D011619:Psychotropic Drugs