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Stage at diagnosis and survival in patients with cancer and a pre-existing mental illness: a meta-analysis
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  • Published on:
    Mental health problems and cancer: kills two birds with one stone
    • Alain Braillon, Senior consultant, University Hospital, Amiens, France

    Davis and colleagues must be commended for their concern about cancer outcomes in patients with mental disorders and for acknowledging the poor quality of research.(1) However, their statement “pre-existing mental disorder have a higher odds of advanced stage cancer at diagnosis “ deserve comment.

    Firstly, patients with mental disorders, as all vulnerable populations, have poor access to care, considering either quantitatively or qualitatively, even more for specialized care, whatever it could be. Accordingly, a vertical approach only targeting patients with mental disorders would only be a partial and symptomatic solution A root cause analysis is a prerequisite to expect fixing a systemic failure.

    Secondly, the term “pre-existing mental disorder” must be questioned as tobacco and alcohol cause both mental health problems and cancer. There is robust and accumulating evidence that cigarette smoking is a causal risk factor for anxiety, depression and, even severe mental illness such as bipolar disorder.(2) Cessation is associated with reduced depression, anxiety and, improved quality of life. While one can understand most patients are fooled by the immediate effects of smoking on perceived stress (decreasing cerebral pain from nicotine withdrawal), the fact that too many psychiatric setting remain smokehouses question the quality of care.(3) Similarly, in many experience, as a second line specialist for severe alcohol use disorders, many of patients referred t...

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    Conflict of Interest:
    None declared.