単科精神病院におけるがんを合併する統合失調症患者状況について

統合失調症患者ががんに罹患した場合，様々な問題が生じる。われわれは，島根大学病院における，がんを合併した統合失調症患者のコンサルテーション・リエゾン状況について検討しているが，精神症状の重い患者では，未治療のまま元の単科精神病院に退院していた。今回，島根県内の単科精神病院における，がんを合併する統合失調症患者のがん治療が，どのような実態であるか，8病院にアンケートを行い，調査時点の状況について回答を得た。8病院の全入院患者数は1,873人で，統合失調症患者は1,090人（58%），そのうちがんを合併している者は10人（1%）であった。 8人がなんらかのがん治療を受け，未治療が2人であった。いずれの精神病院もがんの身体治療を行ってくれる総合病院と連携を図っていた。がんが未治療のままの患者もあり，どう対応するかが今後の課題と思われた。

Patients with schizophrenia who then develop cancer often have a variety of complicated medical and psychiatric problems. We have previously reported on the consultation-liaison service for those patients referred from psychiatric hospitals to our hospital. Patients with severe psychiatric symptoms often returned to thejr original psychiatric hospital without having received adequate cancer treatment. In this report, we surveyed the current state of the cancer treatment of schizophrenic patients at several psychiatric hospitals in Shimane prefecture based on a questionnaire survey. We sent a questionnaire to eight psychiatric hospitals. The total number of inpatients at these 8 hospitals was 1873, including 1090 patients with schizophrenia (58%). Of these schizophrenic patients, ten patients had cancer at that time. Eight patients had received cancer treatment to some degree at affiliated general hospitals, 2 patients, however, could not receive cancer treatment due to either their severe psychotic symptoms or cognitive deterioration. Although some patients received cancer treatment without a sufficient understanding of the cancer diagnosis and treatment, they regularly visited general hospitals for observation. Regarding the preparation for such patients being hospitalized at general hospitals, there was generally a good relationship with the nearby general hospitals. The fact that even a small number of the patients are unable to receive appropriate cancer treatment is thus considered a problem which needs to addressed in the future by our consultation-liaison psychiatrists.