Cancer and injuries more likely in people with serious mental illness
(Medical Xpress) -- People with serious mental illness schizophrenia, bipolar disorder and disabling depression are 2.6 times more likely to develop cancer than the general population, new Johns Hopkins research suggests.
The studys findings, published this month in the journal Psychiatric Services, raise questions about whether patients burdened with serious mental illness are receiving appropriate cancer screenings and preventive care related to risk factors for cancer, such as smoking.
The increased risk is definitely there, but were not entirely sure why, says study leader Gail L. Daumit, M.D., M.H.S., an associate professor of medicine and psychiatry at the Johns Hopkins University School of Medicine. Are these people getting screened? Are they being treated? Somethings going on.
In a separate study, published online last month in the journal Injury Prevention, Daumit found that people with serious mental illness were nearly twice as likely to end up in a hospitals emergency room or inpatient department suffering from an injury than the general population and about 4.5 times more likely to die from their injuries.
Daumit says roughly 5 percent of Americans have a serious mental illness, and this group is known to be two to three times more likely to die prematurely than those without disabling psychiatric problems. A small proportion of the higher risk, she says, can be attributed to the higher risks of suicide and homicide victimization in this population, but those factors do not account for most of the disparity. The top causes of death are cardiovascular disease and cancer, the same top causes of death for those without serious mental illness.
Daumit, a practicing internist, speculates that this population is falling through the cracks.
In the first study, Daumits team looked at data from 3,317 Maryland Medicaid beneficiaries with schizophrenia and bipolar disorder, determining whether they developed cancer between 1994 and 2004 and what type of cancer they had. They found that patients with schizophrenia, when compared to the general population, were more than 4.5 times more likely to develop lung cancer, 3.5 times more likely to develop colorectal cancer and nearly three times more likely to develop breast cancer. People with bipolar disorder experienced similarly high risk for lung, colorectal and breast cancer. There were no racial differences in who developed cancer in this group, whose average age was between 42 and 43 years.
Daumit says one reason for the elevated risk of lung cancer could be smoking, which is more prevalent in people with serious mental illnesses. She also speculates that the breast cancer risk could be related to the fact that women with schizophrenia and bipolar disorder are less likely to have children, and childbearing is believed to reduce breast cancer risk. Also, some psychotropic medications can increase levels of the hormone prolactin, a factor that has been linked to breast cancer. The colorectal cancer risk, she says, could be related to lifestyle issues, such as smoking, lack of physical activity and a diet lacking fruits and vegetables.
Daumit says more study is needed on the role of behavioral and pharmacological factors in increased cancer risk among people with serious mental illness, and the extent to which this population receives appropriate cancer screening and treatment. She says mental health providers and primary care physicians must work together to promote screening as well as to reduce modifiable risk factors such as smoking among this group.
In the second study, Daumit and her colleagues looked at similar Maryland Medicaid data from 1994 through 2001 in search of other patterns. They found that over the seven-year period, 43 percent of the 6,234 people with serious mental illness in the group studied were seen at a hospital emergency department or admitted with an injury. Among the members of the study group with any injury, 42 percent were injured once, 23 percent twice, 25 percent three to five times and 10 percent six or more times.
Superficial injuries, open wounds and sprains were the types of injuries most frequently experienced by those in the study. Poisoning and burns were the least frequent types of injuries. Daumit says the results suggest that people with serious mental illness appear to be at heightened risk for both intentional and unintentional injury, and the types of injuries are mostly consistent with falls and minor violence.
People with serious mental illness are more likely to have substance abuse problems, and being under the influence of drugs or alcohol can increase injury risk, as can being in a location where illegal drugs are sold, Daumit says. But substance abuse rates dont explain all of the increased risk, she says.
Another factor that may be at play, she says, is low socioeconomic status, which is also associated with mental illness and injury risk. She and her team say that environmental risk factors related to poverty that could put people with serious mental illness at increased risk of injury include unsafe housing (without appropriate railings to prevent falls, for example) and poorly maintained neighborhoods (such as those lacking sidewalks).
Just as this population has other medical risks, injury requiring acute medical attention in the emergency department is common and we should consider this when we are looking at the overall care of the patient, Daumit says.
Doctors, she says, need to think about injury risk when counseling patients with serious mental illness and their caregivers. She recommends caregivers touch on such things such as the use of bicycle and motorcycle helmets, safe firearm storage and fall prevention. In addition, she says, physicians should evaluate and address side effects from psychotropic medications such as dizziness, which may lead to unintentional injury.
Other Johns Hopkins researchers involved in the Psychiatric Services study include Emma Elizabeth McGinty, M.S.; Yiyi Zhang, Ph.D.; Eliseo Guallar, M.D., Dr.P.H.; Daniel E. Ford, M.D., M.P.H.; Donald Steinwachs, Ph.D.; and Lisa B. Dixon, M.D., M.P.H.
Daumit, Steinwachs, McGinty and Susan P. Baker, M.P.H., were involved in the Injury Prevention paper.
Provided by Johns Hopkins University
- Tooth loss three times higher in people with serious mental illness Sep 01, 2011 | not rated yet | 0
- Mortality gap for people with serious mental illness is increasing Sep 14, 2011 | not rated yet | 0
- Study links mental health problems to poor prognosis in male cancer patients May 24, 2012 | not rated yet | 0
- Quit smoking message not getting air time in mental health care May 12, 2008 | not rated yet | 0
- Risk of suicide and fatal heart attack immediately following a cancer diagnosis Apr 05, 2012 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
How can there be villous adenoma in colon, if there are no villi there
10 hours ago As title suggest. Thanks :smile:
How can there be a term called "intestinal metaplasia" of stomach
May 21, 2013 Hello everyone, Ok Stomach's normal epithelium is simple columnar, now in intestinal type of adenocarcinoma of stomach it undergoes "intestinal...
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013 From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
Ratio of Hydrogen of Oxygen in Dessicated Animal Protein
May 13, 2013 As an experiment, for the past few months I've been consuming at least one portion of Jell-O or unflavored Knox gelatin per day. I'm 64, in very...
- More from Physics Forums - Medical Sciences
More news stories
A new study shows there is a gender gap when it comes to behavior and self-control in American young children – one that does not appear to exist in children in Asia.
Psychology & Psychiatry 44 minutes ago | not rated yet | 0
Until now, little was scientifically known about the human potential to cultivate compassion—the emotional state of caring for people who are suffering in a way that motivates altruistic behavior.
Psychology & Psychiatry 1 hour ago | not rated yet | 0 |
What effect does a father's depression have on his young son or daughter? When fathers report a high level of emotional intimacy in their marriage, their children benefit, said a University of Illinois study.
Psychology & Psychiatry 2 hours ago | not rated yet | 0
(Medical Xpress)—Preschoolers universally recognize that one's choices are not always free – that our decisions may be constrained by social obligations to be nice to others or follow rules set by parents ...
Psychology & Psychiatry 9 hours ago | not rated yet | 0
(Medical Xpress)—Do ethicists engage in better moral behavior than other professors? The answer is no. Nor are they more likely than nonethicists to act according to values they espouse, according to researchers from the ...
Psychology & Psychiatry 9 hours ago | 5 / 5 (1) | 0
(HealthDay)—Implementation of systematic monitoring for medication adherence will allow for identification of barriers to adherence and tailoring of interventions, according to a viewpoint piece published ...
10 minutes ago | not rated yet | 0
Every day, their baby stopped breathing, his collapsed bronchus blocking the crucial flow of air to his lungs. April and Bryan Gionfriddo watched helplessly, just praying that somehow the dire predictions weren't true.
40 minutes ago | 5 / 5 (1) | 0
As the world prepares for what may be the next pandemic strain of influenza virus, in the H7N9 bird flu, a new UC Irvine study reveals that the 2009 H1N1 swine flu pandemic was deadliest for people under the age of 65, while ...
40 minutes ago | not rated yet | 0
(HealthDay)—The American Cancer Society, which is celebrating on Wednesday a century of fighting a disease once viewed as a death sentence, is making a pledge to put itself out of business.
10 minutes ago | not rated yet | 0
National Lung Screening Trial (NLST) investigators also conclude that the 20 percent reduction in lung cancer mortality with low-dose computed tomography (LDCT) versus chest X-ray (CXR) screening previously reported in the ...
36 minutes ago | not rated yet | 0
1 hour ago | 5 / 5 (1) | 0 |