End of life breast cancer care in women with severe mental illnesses

Abstract Little is known on the end-of-life (EOL) care of terminal breast cancer in women with severe psychiatric disorder (SPD). The objective was to determine if women with SPD and terminal breast cancer received the same palliative and high-intensity care during their end-of-life than women witho...

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Autores principales:	Guillaume Fond, Vanessa Pauly, Audrey Duba, Sebastien Salas, Marie Viprey, Karine Baumstarck, Veronica Orleans, Pierre-Michel Llorca, Christophe Lancon, Pascal Auquier, Laurent Boyer
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/8864e90a2faa41829565475a8e859064
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spelling	oai:doaj.org-article:8864e90a2faa41829565475a8e8590642021-12-02T15:55:18ZEnd of life breast cancer care in women with severe mental illnesses10.1038/s41598-021-89726-y2045-2322https://doaj.org/article/8864e90a2faa41829565475a8e8590642021-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-89726-yhttps://doaj.org/toc/2045-2322Abstract Little is known on the end-of-life (EOL) care of terminal breast cancer in women with severe psychiatric disorder (SPD). The objective was to determine if women with SPD and terminal breast cancer received the same palliative and high-intensity care during their end-of-life than women without SPD. Study design, setting, participants. This population-based cohort study included all women aged 15 and older who died from breast cancer in hospitals in France (2014–2018). Key measurements/outcomes. Indicators of palliative care and high-intensity EOL care. Multivariable models were performed, adjusted for age at death, year of death, social deprivation, duration between cancer diagnosis and death, metastases, comorbidity, smoking addiction and hospital category. The analysis included 1742 women with SPD (287 with bipolar disorder, 1075 with major depression and 380 with schizophrenia) and 36,870 women without SPD. In multivariate analyses, women with SPD had more palliative care (adjusted odd ratio aOR 1.320, 95%CI [1.153–1.511], p < 0.001), longer palliative care follow-up before death (adjusted beta = 1.456, 95%CI (1.357–1.555), p < 0.001), less chemotherapy, surgery, imaging/endoscopy, and admission in emergency department and intensive care unit. Among women with SPD, women with bipolar disorders and schizophrenia died 5 years younger than those with recurrent major depression. The survival time was also shortened in women with schizophrenia. Despite more palliative care and less high-intensity care in women with SPD, our findings also suggest the existence of health disparities in women with bipolar disorders and schizophrenia compared to women with recurrent major depression and without SPD. Targeted interventions may be needed for women with bipolar disorders and schizophrenia to prevent these health disparities.Guillaume FondVanessa PaulyAudrey DubaSebastien SalasMarie VipreyKarine BaumstarckVeronica OrleansPierre-Michel LlorcaChristophe LanconPascal AuquierLaurent BoyerNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Guillaume Fond Vanessa Pauly Audrey Duba Sebastien Salas Marie Viprey Karine Baumstarck Veronica Orleans Pierre-Michel Llorca Christophe Lancon Pascal Auquier Laurent Boyer End of life breast cancer care in women with severe mental illnesses
description	Abstract Little is known on the end-of-life (EOL) care of terminal breast cancer in women with severe psychiatric disorder (SPD). The objective was to determine if women with SPD and terminal breast cancer received the same palliative and high-intensity care during their end-of-life than women without SPD. Study design, setting, participants. This population-based cohort study included all women aged 15 and older who died from breast cancer in hospitals in France (2014–2018). Key measurements/outcomes. Indicators of palliative care and high-intensity EOL care. Multivariable models were performed, adjusted for age at death, year of death, social deprivation, duration between cancer diagnosis and death, metastases, comorbidity, smoking addiction and hospital category. The analysis included 1742 women with SPD (287 with bipolar disorder, 1075 with major depression and 380 with schizophrenia) and 36,870 women without SPD. In multivariate analyses, women with SPD had more palliative care (adjusted odd ratio aOR 1.320, 95%CI [1.153–1.511], p < 0.001), longer palliative care follow-up before death (adjusted beta = 1.456, 95%CI (1.357–1.555), p < 0.001), less chemotherapy, surgery, imaging/endoscopy, and admission in emergency department and intensive care unit. Among women with SPD, women with bipolar disorders and schizophrenia died 5 years younger than those with recurrent major depression. The survival time was also shortened in women with schizophrenia. Despite more palliative care and less high-intensity care in women with SPD, our findings also suggest the existence of health disparities in women with bipolar disorders and schizophrenia compared to women with recurrent major depression and without SPD. Targeted interventions may be needed for women with bipolar disorders and schizophrenia to prevent these health disparities.
format	article
author	Guillaume Fond Vanessa Pauly Audrey Duba Sebastien Salas Marie Viprey Karine Baumstarck Veronica Orleans Pierre-Michel Llorca Christophe Lancon Pascal Auquier Laurent Boyer
author_facet	Guillaume Fond Vanessa Pauly Audrey Duba Sebastien Salas Marie Viprey Karine Baumstarck Veronica Orleans Pierre-Michel Llorca Christophe Lancon Pascal Auquier Laurent Boyer
author_sort	Guillaume Fond
title	End of life breast cancer care in women with severe mental illnesses
title_short	End of life breast cancer care in women with severe mental illnesses
title_full	End of life breast cancer care in women with severe mental illnesses
title_fullStr	End of life breast cancer care in women with severe mental illnesses
title_full_unstemmed	End of life breast cancer care in women with severe mental illnesses
title_sort	end of life breast cancer care in women with severe mental illnesses
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/8864e90a2faa41829565475a8e859064
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End of life breast cancer care in women with severe mental illnesses

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