Neuropsychiatric disturbance in cancer patients with epidural spinal cord compression receiving high dose corticosteroids: A prospective comparison study Journal Article
| Authors: | Breitbart, W.; Stiefel, F.; Kornblith, A. B.; Pannullo, S. |
| Article Title: | Neuropsychiatric disturbance in cancer patients with epidural spinal cord compression receiving high dose corticosteroids: A prospective comparison study |
| Abstract: | In order to examine the impact of corticosteroids upon psychiatric symptomatology in cancer patients, we prospectively studied two groups: 50 cancer patients with epidural spinal cord compression (ESCC) receiving a standard tapering course of high‐dose dexamethasone (i.e. 100 mg loading dose followed by 96 mg per day tapered to 0 mg over 3–4 weeks), and a comparison group of 50 patients with the same cancer diagnoses and a similar extent of metastatic disease but without ESCC who did not receive dexamethasone. Psychiatric disorder, psychological distress, pain, mental status, physical performance status, medical events, and psychotropic and analgesic use were assessed in both groups at four points during the course of corticosteroid therapy or hospitalization. Measures included: (1) DSM‐III‐R psychiatric diagnosis; (2) Brief Psychiatric Rating Scale; (3) Hamilton Depression Scale; (4) Hamilton Anxiety Rating Scale; (5) Profile of Mood States; (6) Memorial Pain Assessment Card; (7) Mini‐Mental State Examination; and (8) Karnofsky Performance Status Score. While the overall rate of DSM‐III‐R psychiatric disorders was not significantly different between groups, patients receiving corticosteroids had a significantly greater incidence of major depressive syndromes (x2 = 6.08, p < 0.05), in particular organic mood disorder—depressed (x2 = 6.40, p < 0.05). There was also a tendency for a greater incidence of delirium (x2 = = p < 0.10) in the corticosteroid group. The corticosteroid group was significantly more depressed than the comparison group over time as measured by the non‐somatic items of the Hamilton Depression Rating Scale (F = 3.98, p < 0.02), and more anxious, as measured by the non‐somatic items of the Hamilton Anxiety Rating Scale (p < 0.10). Thus, a tapering regimen of high‐dose corticosteroids has an influence on the incidence and nature of neuropsychiatric disturbance in cancer patients with ESCC, resulting in a significantly greater incidence of depressive symptoms and disorders. Copyright © 1993 John Wiley & Sons, Ltd |
| Journal Title: | Psycho-Oncology |
| Volume: | 2 |
| Issue: | 4 |
| ISSN: | 1057-9249 |
| Publisher: | John Wiley & Sons |
| Date Published: | 1993-12-01 |
| Start Page: | 233 |
| End Page: | 245 |
| Language: | English |
| DOI: | 10.1002/pon.2960020404 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Source: Scopus |
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