Depressive symptoms, smoking, drinking, and quality of life among head and neck cancer patients.

The authors examined the relationship between depressive symptoms, smoking, problem drinking, and quality of life among 973 head and neck cancer patients who were surveyed and had their charts audited. Forty-six percent screened positive for depressive symptoms, 30% smoked, and 16% screened positive for problem drinking. Controlling for clinical and demographic variables, linear-regression analyses showed that depressive symptoms had a strong negative association with all 12 quality-of-life scales; smoking had a negative association on all but one of the quality-of-life scales; and problem drinking was not associated with any of the quality-of-life scales.

A tailored smoking, alcohol, and depression intervention for head and neck cancer patients.

Background: Smoking, alcohol use, and depression are interrelated and highly prevalent in patients with head and neck cancer, adversely affecting quality of life and survival. Smoking, alcohol, and depression share common treatments, such as cognitive behavioral therapy and antidepressants. Consequently, we developed and tested a tailored smoking, alcohol, and depression intervention for patients with head and neck cancer.

New-onset type-2 diabetes associated with atypical antipsychotic medications.

Purpose: This study compared the one-year incidence of new-onset type-2 diabetes mellitus (DM) and changes in weight in patients with a variety of psychiatric diagnoses prescribed olanzapine, risperidone, or quetiapine, compared to a reference group receiving haloperidol and no other antipsychotic medication.

Research Design And Methods: Data was abstracted from charts of subjects newly initiated and then maintained for one year on olanzapine (n=112), risperidone (n=100), quetiapine (n=100), and haloperidol (n=100). Baseline and one-year DM status, height, and weight were collected, as well as concurrent psychotropic medications, medical and psychiatric comorbidities.

Aripiprazole in the management of post-traumatic stress disorder symptoms in returning Global War on Terrorism veterans.

The present study illustrates the potential use of aripiprazole as part of the management of post-traumatic stress disorder (PTSD) in returning Global War on Terrorism (GWOT) veterans. Five consecutive cases of GWOT combat-related PTSD, managed in part with the atypical antipsychotic medication aripiprazole, are presented and discussed. In four of the five cases reported, the medication was well-tolerated and was effective in the management of sleep disturbances, such as nightmares and agitated behaviours during sleep, and was also helpful in the management of hyper-arousal.

Cigarettes, alcohol, and depression: characterizing head and neck cancer survivors in two systems of care.

Tobacco exposure is a key risk factor for head and neck cancer, and continued smoking after diagnosis negatively affects outcomes. The present study examined tobacco smoking, nicotine dependence, alcohol use, and depression in survivors of head and neck cancer. Subjects at least 6 months post-initial diagnosis of head and neck cancer (N=694) drawn from three VA otolaryngology clinics (n=309, VA patients) and a university-based otolaryngology clinic (n=385, non-VA patients) were administered questionnaires and standardized rating instruments for nicotine and alcohol dependence and for depression.

Disability in patients with head and neck cancer.

Background: Patients with head and neck cancer often experience debilitating speech, eating, and respiratory problems as well as the psychological effects of loss of function and change in body image. These patients often become unemployed as a result of their disease process, which adds financial burden to their already stressful lives. Yet the specific factors associated with unemployment have not been systematically studied.

Five-year outcomes following psychiatric consultation to a tertiary care emergency room.

Objective: The authors prospectively examined inpatient psychiatric hospitalization and mortality rates of psychiatric patients seen in the emergency room of a large Department of Veterans Affairs medical center.

Method: Charts of 504 patients receiving evening psychiatric consultation during a 13-month period were assessed 5 years after the consultation to determine rates of psychiatric hospitalization and mortality.

Results: Patients with multiple psychiatric diagnoses, including comorbid addiction disorders, had significantly higher rates of psychiatric hospitalization 5 years after an emergency room visit.

Linking mental health and addiction services: a continuity-of-care team model.

Reorganization of mental health care delivery services at a Department of Veterans Affairs medical center addressed problems with the coordination of addiction treatment and mental health programming for patients with significant psychiatric and addiction comorbidity. Clinical services were organized into interdisciplinary continuity-of-care teams that follow patients across different levels of care. The teams provide addiction treatment through "universally available" resources such as a partial hospital addiction rehabilitation module.