Steriod-associated psychiatric burden in cancer patients

This study explores the role of steroid administration in identifying distressed or even mentally disordered cancer patients (so-called case finding). Charts of 12 298 cancer patients (4499 treated with prednisone equivalents) were analysed descriptively. A subset of 10 945 was further explored via latent class analysis (LCA). LCA avoids confounding by indication because it subgroups patients without prior preconceptions based on homogeneous expression of traits (i.e. the variables examined). LCA identified four subgroups: two subgroups with high dosages of prednisone equivalent (>= 80 mg/day on average over all treatment days) and two with low dosages. The two subgroups with high average dosages had an increased likelihood of psychotropic drug administration, but only one was more likely to require 1:1 observation. In one subgroup, low dosages of prednisone equivlents correlated with a slightly increased probability for a psychiatric assessment and psychotropic drug administration. The subgroup least likely to receive steroid treatment was also the least likely to receive a psychiatric assessment and psychotropic drug administration. Descriptive statistics on age, sex, cumulative inpatient treatment, type of cancer, stage of cancer at first diagnosis, mental disorders, severe mental disorders and psychotropic drug administration (antidepressants, antipsychotics, benzodiazepines, anticonvulsants/mood stabilizers, opioids) are provided for patients receiving no, less and more than 80 mg of prednisone equivalent.

Automated summary

This study investigates the role of steroid treatment in identifying cancer patients who are distressed or mentally disordered. By analyzing the medical records of 12,298 cancer patients, the study identifies four subgroups of patients using different dosages of prednisone equivalents. The study finds that patients with higher dosages of prednisone are more likely to receive psychotropic drug administration, while patients with lower dosages have a slightly increased probability of psychiatric assessment and psychotropic drug administration. The subgroup with the lowest probability of receiving steroid treatment also has the lowest likelihood of receiving psychiatric assessment and psychotropic drug administration.