PSYCHIATRIC LIAISON ISSUES IN CANCER CARE IN JAPAN

To clarify the psychiatric liaison issues in Japan, this paper briefly introduces a survey of physician attitudes and practices regarding cancer care in Japan and preliminarily reports on an ''active'' liaison program developed at one Japanese general hospital. The survey of physicians from 31 teaching hospitals, including all cancer centers, revealed that 56 % of physicians do not inform patients of a diagnosis of cancer. Thus, actual psychiatric consultation referrals were very few due to the physician's fear of harming his relationship with the cancer patient. One medical unit, in which about one-quarter of the cancer patients were told their diagnoses by the unit chief physician, showed significantly higher rates of psychiatric consultation after the introduction of an ''active'' liaison program in that hospital. These results suggest that the liaison program can positively influence the rate of psychiatric consultation referrals for cancer patients when the physician discloses the diagnosis to the patient. Consultation-liaison psychiatry in cancer care is expected to develop in Japan, because most physicians report a trend toward informing patients of their cancer diagnosis.