Talking Points by Barry Rosenfeld, Ph.D.

Talking Points by Barry Rosenfeld, Ph.D.
Relevant Statistics - Mental Health and End-Of-Life Care

Pain and Symptom Management:

More than 60% of patients with cancer and AIDS experience persistent pain ^1,2
42% of patients with cancer are under-medicated for their pain ¹
86% of patients with AIDS are under-medicated for their pain ²
50% of doctors fear that their patients will become addicted to pain medications ³
less than 1 % of cancer patients actually become dependent on pain medications ⁴
12 % of doctors receive "good" training in pain management/palliative care in medical school ⁵

Mental Health Care:

15-20% of terminally ill patients are diagnosed with a "major depression" ^6,7
49% of severely depressed cancer patients are considered (by their doctor) to have NO depression ⁸
70-80% of terminally ill patients with depression respond to treatment (when provided) ⁹
roughly 50% of suicides in terminally ill patients are attributable to untreated depression ⁹
25% of elderly depressed patients changed their minds about end-of-life interventions after treatment ¹¹

Barry Rosenfeld, Ph.D., is an Associate Professor of Psychology at Fordham University where he teaches in the graduate program in Clinical Psychology.

References:

^{1 Cleeland, C. S., Gonin, R., Hatfield, A. K., et al.
(1994). Pain and its treatment in outpatients with metastatic cancer. New
England Journal of Medicine, 330, 592-596.
^{2 Breitbart, W., Rosenfeld, B., McDonald, M., et al.
(1996). Undertreatment of pain in ambulatory AIDS patients. Pain, 65, 243-249.
^{3 Breitbart, W., Kaim, M., and Rosenfeld, B. (1999).
Clinicians? perceptions of barriers to pain management in AIDS. Journal of Pain
and Symptom Management, 18, 203-212.
^{4 Passik, S. D., Kirsch, K. L., McDonald, M. V., et al.
(2000). A pilot survey of aberrant drug-taking attitudes and behavior in samples
of cancer and AIDS patients. Journal of Pain and Symptom Management, 19,
274-286.
^{5 Breitbart, W., Rosenfeld, B., and Passik, S. (1998). The
Network Project: A multidisciplinary cancer education and training program in
pain management, rehabilitation and psychosocial issues. Journal of Pain and
Symptom Management, 15(1), 18-26.
^{6 Rosenfeld, B. (1998). Psychological sequelae of HIV
disease and HIV-associated neoplasms. In J. Holland (Ed.) Handbook of
Psycho-Oncology, 2nd Ed. New York: Oxford, 861-897.
^{7 Chochinov, H. M., Wilson, K. G., Enns, M., and Lander,
S. (1994). Prevalence of depression in the terminally ill: effects of diagnostic
criteria and symptom threshold judgments. American Journal of Psychiatry, 151,
537-540.
^{8 Passik, S. D., Dugan, W., McDonald, M. V., Rosenfeld,
B., Theobald, D., and Edgerton, S. (1998). Oncologist?s recognition of
depression in their patients with cancer. Journal of Clinical Oncology, 16,
1594-1600.
^{9 Foley, K. M. (1995). Pain, physician-assisted suicide,
and euthanasia. Pain Forum, 4, 163-178.
^{10 Lee, M. A., Smith, D. M., Fenn, D. S., & Ganzini,
L. (1998) Do patients' treatment decisions match advance statements of their
preferences? Journal of Clinical Ethics, 9, 258-262.

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