People with severe mental disorders (SMDs) have a higher mortality rate and reduced life expectancy compared to the general population. Factors that contribute to higher mortality rates include a higher rate of smoking and increased incidence of obesity from lifestyle, diet, or medication side effects. Cancer treatment may exacerbate mood and psychotic symptoms in patients with SMD. Some of the medications used in cancer treatment or the medications used to alleviate the side effects of cancer treatment can have adverse reactions with psychotropic medications. This article examines problems that patients with SMD encounter with their cancer diagnosis and treatment. Oncology nurses in any clinical setting play a pivotal role in identifying the special needs of a patient with SMD and must become familiar with psychosocial issues, psychotropic medications, and SMD to educate and advocate for these patients and their families. Collaborating and coordinating care between oncology and psychiatry providers is needed for optimal patient outcomes.

Objective To review evidence from longitudinal studies on the association between prescription opioid use and common mood and anxiety symptoms. Design We conducted a systematic review and meta-analysis according to PRISMA guidelines. Methods We searched PubMed, Embase and PsycINFO for search terms related to opioids AND (depression OR bipolar OR anxiety OR post-traumatic stress disorder [PTSD]). Findings were summarised narratively, and random-effects meta-analyses were used to pool effect sizes. Results We identified 10,290 records and found 10 papers that met our inclusion criteria. Incidence studies showed that people who used prescription opioids had an elevated risk of any mood (adjusted effect size [aES]=1.80 [1.40-2.30]), and anxiety outcomes (aES=1.40 [1.20-1.80]), compared to those who did not. Associations with depression were small and not significant after adjusting for potential confounders (aES=1.18 [0.98-1.41]). However, some studies reported an increased risk of depressive symptoms after increased (aES=1.58 [1.30-1.93]) or prolonged opioid use (aES=1.49 [1.19-1.86]). Conclusions Mental health should be considered when prescribing opioids because some patients may be vulnerable to adverse mental health outcomes.

No abstract