Psychiatric symptoms of pediatric cancer pain

This study investigated the contribution of pain to psychiatric symptoms in 43 hospitalized children and adolescents referred for psychiatric evaluation in a pediatric cancer center during a 1-yr period. Procedures included determination of the primary reason for referral, child and parent diagnostic interviews assessing pain history and psychiatric symptoms, and recommendations for improved pain control or other types of intervention and followup. Across the four referral categories (for symptoms of depression, cognitive/perceptual disturbance, anxiety, or disruptive behavior), approximately 20% of all consultations resulted in a primary recommendation for improved pain control. The findings suggest that pediatric cancer pain may go untreated when its manifestations are psychiatric. Implications for staff education, consultation-liaison psychiatry, and psychiatric nosology are discussed.