Involvement of a Psychiatric Consultation Service in a Palliative Care Team at the Japanese Cancer Center Hospital

Close collaboration between the cancer care team service and the psychiatric consultation service is recommended to provide adequate comprehensive care to cancer patients. In Japan, specialized palliative care teams work in conjunction with consultation-liaison psychiatrists as an essential members. There are, however, few studies reporting on these services. We obtained the characteristics, physical and psychiatric symptoms and outcomes of cancer patients by analyzing the database of patients referred to the palliative care team at the National Cancer Center Hospital East, Japan. Among consecutive 2000 referrals, most patients referred to the palliative care team present both physical and psychiatric symptoms. Psychiatric diagnoses were provided for similar to 70% of these patients. Consultation-liaison psychiatrists provided medical care to 80% of all the referrals. The main symptoms for psychiatric consultation were delirium (28%), adjustment disorder (18%), major depression (7.6%) and dementia (6.6%). Psychiatric problems are common in cancer patients of the palliative care team. The palliative care team should assess the psychiatric problems in cancer patients, and the involvement of the consultation-liaison psychiatrists in the palliative care teams may be one of the strategies to establish the psychosocial support for cancer patients in the acute hospital settings.