Psychiatric liaison to gynecological oncology

AbstractA psychiatric liaison to the Gynecologic Oncology Service at a major cancer center was begun in July 1991 to improve the psychosocial care. A total of 82 women were evaluated by a psychiatric consultant over a 12‐month period. Most had advanced gynecological disease with poor prognosis. Consultation requests came from the nursing staff (42%), the gynecological fellow (34%) and the attending gynecologist (24%). Reasons for consultations were: difficulty coping (45%), depression (38%), social issues (7%) and ‘other’ (10%). The initial psychosocial issues were: patient‐related problems (62%), staff issues (28%) and family/social issues (10%). The patient‐related problems were: difficulty coping (43%), depression (33%), anxiety (16%) and delirium (8%). Upon initial assessment, the women met DSM‐III‐R diagnoses of adjustment disorder (53%) with depressed mood (32%), with mixed features (12%), with anxious mood (9%), major depression (13%), delirium (12%), panic attack with agoraphobia (4%), dementia (4%), schizophrenia (4%), ‘other’ (5%). After the initial consultation 28% developed delirium. ‘Other’ consisted of two women with a history of substance dependence and borderline pe