#27 Mental Health in FAP

Study #27

This was a groundbreaking study in exploring the mental health of patients with FAP It led to our provision of a dedicated psychologist to such patients.

Wood E; Church J; O'Malley M; LaGuardia L; Heald B; Burke C; Kalady M. Mental Health Symptoms in Patients With Familial Adenomatous Polyposis: An Observational Study. Dis Colon & Rectum 2019; 62: 1204-1211.

Background: Almost all patients with familial adenomatous polyposis undergo abdominal surgery with a risk of disease and surgery-related complications. This, the familial nature of the syndrome, and its wide-ranging manifestations make patients prone to mental health symptoms. If this is true, patients need appropriate evaluation and treatment.

Objective: The purpose of this study was to record the experience of mental health symptoms in a group of unselected patients with FAP.

Design: We conducted an observational study using an anonymized mental health symptom survey for patients affected with familial adenomatous polyposis.

Settings: The study was conducted using the Hereditary Colorectal Cancer Registry in a tertiary referral center.

Patients: Patients affected with familial adenomatous polyposis were included.

Main outcome measures: Results of the mental health survey were measured.

Results: Seventy nine of 100 patients completed the survey; 57 endorsed ≥1 psychosocial symptom (72.2%). with a mean of 4 per patient. Nine patients (11.4%) met all 4 of the American Psychiatric Association diagnostic criteria for posttraumatic stress disorder, and 8 (10.1%) endorsed partial posttraumatic stress disorder criteria (3/4 symptoms). Patients who met all of the criteria for posttraumatic stress disorder had an average of 9.3 psychosocial symptoms each compared with 8.3 for those who met 3 of 4 and 2.2 for those who met <3. Six patients endorsed suicidal thoughts, all of whom met 3 or 4 of the criteria for posttraumatic stress disorder.

Limitations: The study was limited by its referral bias toward severe cases and relatively small number of patients. Because of the limitations of an anonymous self-administered screening, no mental health diagnoses have been given.

Conclusions: Patients with familial adenomatous polyposis are at risk for mental health symptoms, which can be multiple and severe. Some patients need professional counseling. A correlation between familial adenomatous polyposis patients with posttraumatic stress disorder and suicidal ideation is important.