Women with a diagnosis of Severe Mental Illness (SMI), such as schizophrenia, bipolar disorder or schizoaffective disorder, remain in a particularly difficult clinical position, being at the interface of two highly stigmatised areas of healthcare: psychiatry and oncology. Although their incidence of cancer, including breast cancer, is similar to the general population, mortality remains significantly higher in this group of patients. These data have direct implications for clinical practice, pointing to the need for a more integrated and personalised therapeutic approach.
The aim of our presentation is to discuss the practical experience of working with patients with a dual diagnosis on the basis of a case study and to analyse the barriers encountered at the stage of oncological diagnosis and treatment. Based on the literature review and pilot in-depth interviews (n = 10), four key areas for clinical intervention were identified:
(1) diagnostic delays due to underestimation of somatic symptoms in psychiatric patients,
(2) insufficient collaboration between specialist teams,
(3) limited availability of integrated psycho-oncological support,
(4) the impact of anticancer treatment on the destabilisation of the mental state.
It is important to develop recommendations for clinical practice, including the need to create integrated diagnostic and therapeutic pathways and to implement dedicated psycho-oncological support at the interface between psychiatry and oncology. Only a multidisciplinary approach can realistically improve the prognosis and quality of life of this vulnerable group of patients.