Hostname: page-component-797576ffbb-42xl8 Total loading time: 0 Render date: 2023-12-04T09:17:29.942Z Has data issue: false Feature Flags: { "corePageComponentGetUserInfoFromSharedSession": true, "coreDisableEcommerce": false, "useRatesEcommerce": true } hasContentIssue false

Thiamine deficiency in the bereaved after cancer-related spousal loss

Published online by Cambridge University Press:  20 May 2019

Hideki Onishi*
Affiliation:
Department of Psycho-oncology, Saitama Medical University International Medical Center, Saitama, Japan
Nozomu Uchida
Affiliation:
Department of General Medicine, Ogano Town Central Hospital, Saitama, Japan
Takao Takahashi
Affiliation:
Department of Supportive Medicine, Saitama Medical University International Medical Center, Saitama, Japan
Daisuke Furuya
Affiliation:
Department of General Medicine, Saitama Medical University International Medical Center, Saitama, Japan
Yasuhiro Ebihara
Affiliation:
Department of Laboratory Medicine, Saitama Medical University International Medical Center, Saitama, Japan
Izumi Sato
Affiliation:
Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
Hiroshi Ito
Affiliation:
Ito Internal Medicine and Pediatric Clinic, Fukuoka, Japan
Mayumi Ishida
Affiliation:
Department of Psycho-oncology, Saitama Medical University International Medical Center, Saitama, Japan
*
Author for correspondence: Hideki Onishi, Department of Psycho-oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka City, Saitama 350-1298, Japan. Email: honishi@saitama-med.ac.jp

Abstract

Objective

Thiamine deficiency (TD) is recognized in various kinds of disease with associated loss of appetite including cancer. However, it has not been recognized to date in bereaved partners after spousal loss from cancer.

Method

From a series of bereaved partners who lost a spouse to cancer, we report on those who developed TD after bereavement.

Result

Case 1 was a 57-year-old woman who sought consultation at our “bereavement clinic.” Her husband had been diagnosed with pancreatic cancer one year earlier and had died one month previously. At the first visit, she was observed to suffer depression, anxiety, and decreased appetite. Neurological, blood, and biochemical examinations did not reveal any noteworthy findings. She was diagnosed with uncomplicated bereavement. Detailed examination revealed that her appetite had been markedly decreased for approximately five weeks. The diagnosis of TD was supported by her abnormally low serum thiamine level. Case 2 was a bereaved 73-year-old male who had lost his wife to hypopharyngeal cancer one month previously after a five-year illness. He had shown a lack of energy for the month preceding his wife's death, but because there was no improvement after her death, his family recommended he seek consultation at our “bereavement clinic.” He was suffering from major depressive disorder. Detailed examination revealed that his appetite had been decreased for more than two weeks. Again, the diagnosis of TD was supported by his abnormally low serum thiamine level.

Significance of results

These reports demonstrate that there is a possibility that bereaved could develop TD after the loss of a loved one. TD should be considered whenever there is a loss of appetite lasting for more than 2 weeks, and medical staff should pay careful attention to the physical condition of the bereaved to prevent complications because of TD.

Type
Case Report
Copyright
Copyright © Cambridge University Press 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th ed, Washington DC: American Psychiatric Publishing.Google Scholar
Carey, IM, Shah, SM, DeWilde, S, et al. (2014) Increased risk of acute cardiovascular events after partner bereavement: A matched cohort study. JAMA Internal Medicine 174(4), 598605.Google Scholar
Chen, MF, Chen, LT, Gold, M, et al. (1996) Plasma and erythrocyte thiamin concentrations in geriatric outpatients. Journal of the American College of Nutrition 15(3), 231236.Google Scholar
Cole, MG and Dendukuri, N (2003) Risk factors for depression among elderly community subjects: A systematic review and meta-analysis. American Journal Psychiatry 160(6), 11471156.Google Scholar
Erlangsen, A, Jeune, B, Bille-Brahe, U, et al. (2004) Loss of partner and suicide risks among oldest old: A population-based register study. Age and Ageing 33(4), 378383.Google Scholar
Galvin, R, Brathen, G, Ivashynka, A, et al. (2010) EFNS guidelines for diagnosis, therapy and prevention of Wernicke encephalopathy. European Journal of Neurology 17(12), 14081418.Google Scholar
Holmes, TH and Rahe, RH (1967) The social readjustment rating scale. Journal of Psychosometric Research 11(2), 213218.Google Scholar
Isenberg-Grzeda, E, Alici, Y, Hatzoglou, V, et al. (2016a) Nonalcoholic thiamine-related encephalopathy (Wernicke-Korsakoff syndrome) among inpatients with cancer: A series of 18 cases. Psychosomatics 57(1), 7181.Google Scholar
Isenberg-Grzeda, E, Hsu, AJ, Hatzoglou, V, et al. (2015) Palliative treatment of thiamine-related encephalopathy (Wernicke's encephalopathy) in cancer: A case series and review of the literature. Palliative and Supportive Care 13(5):12411249.Google Scholar
Isenberg-Grzeda, E, Kutner, HE, and Nicolson, SE (2012) Wernicke-Korsakoff-syndrome: Under-recognized and under-treated. Psychosomatics 53(6), 507516.Google Scholar
Isenberg-Grzeda, E, Rahane, S, DeRosa, AP, et al. (2016b) Wernicke-Korsakoff syndrome in patients with cancer: A systematic review. Lancet Oncology 17(4), e142e148.Google Scholar
Isenberg-Grzeda, E, Shen, MJ, Alici, Y, et al. (2017) High rate of thiamine deficiency among inpatients with cancer referred for psychiatric consultation: Results of a single site prevalence study. Psychooncology 26(9), 13841389.Google Scholar
Ishida, M, Onishi, H, Wada, M, et al. (2010) Bereavement dream? Successful antidepressant treatment for bereavement-related distressing dreams in patients with major depression. Palliative and Supportive Care 8(1), 9598.Google Scholar
Ishida, M, Onishi, H, Wada, M, et al. (2011) Psychiatric disorders in patients who lost family members to cancer and asked for medical help: descriptive analysis of outpatient services for bereaved families at Japanese cancer center hospital. Japanese Journal of Clinical Oncology 41(3), 380385.Google Scholar
Ishida, M, Onishi, H, Wada, M, et al. (2012) Psychological distress of the bereaved seeking medical counseling at a cancer center. Japanese Journal of Clinical Oncology 42(6), 506512.Google Scholar
Ishida, M, Onishi, H, Toyama, H, et al. (2015) Missing memories of death: Dissociative amnesia in the bereaved the day after a cancer death. Palliative and Supportive Care 13(6), 17871790.Google Scholar
Ishida, M, Onishi, H, Morita, T, et al. (2018) Communication disparity between the bereaved and others: What hurts them and what is unhelpful? A nationwide study of the cancer bereaved. Journal of Pain and Symptom Management 55(4), 10611067.e1061.Google Scholar
Kaprio, J, Koskenvuo, M, and Rita, H (1987) Mortality after bereavement: A prospective study of 95,647 widowed persons. American Journal of Public Health 77(3), 283287.Google Scholar
Li, G (1995) The interaction effect of bereavement and sex on the risk of suicide in the elderly: An historical cohort study. Social Science & Medicine 40(6), 825828.Google Scholar
MacLean, LD, Rhode, BM, and Shizgal, HM (1983) Nutrition following gastric operations for morbid obesity. Annals of Surgury 198(3), 347355.Google Scholar
Nichols, HK and Basu, TK (1994) Thiamin status of the elderly: Dietary intake and thiamin pyrophosphate response. Journal of the American College of Nutrition 13(1), 5761.Google Scholar
Onishi, H, Ishida, M, Kagamu, H, et al. (2018a) Wernicke encephalopathy in a lung cancer patient during treatment with nivolumab. Palliative and Supportive Care 13.Google Scholar
Onishi, H, Ishida, M, Takahashi, T, et al. (2018b) Wernicke encephalopathy without delirium that appeared as agitation in a patient with lung cancer. Palliative and Supportive Care 16(6):800802.Google Scholar
Onishi, H, Ishida, M, Tanahashi, I, et al. (2018c) Early detection and successful treatment of Wernicke's encephalopathy in outpatients without the complete classic triad of symptoms who attended a psycho-oncology clinic. Palliative and Supportive Care 16(5), 633636.Google Scholar
Onishi, H, Ishida, M, Tanahashi, I, et al. (2018d). Subclinical thiamine deficiency in patients with abdominal cancer. Palliative and Supportive Care 16(4), 497499.Google Scholar
Onishi, H, Ishida, M, Tanahashi, I, et al. (2018e) Wernicke encephalopathy without delirium in patients with cancer. Palliative and Supportive Care 16(1), 118121.Google Scholar
Onishi, H, Ishida, M, Toyama, H, et al. (2016) Early detection and successful treatment of Wernicke encephalopathy in a patient with advanced carcinoma of the external genitalia during chemotherapy. Palliative and Supportive Care 14(3), 302306.Google Scholar
Onishi, H, Ishida, M, Uchida, N, et al. (2018f) Subclinical thiamine deficiency identified by preoperative evaluation in an ovarian cancer patient: Diagnosis and the need for preoperative thiamine measurement. Palliative and Supportive Care 12.Google Scholar
Onishi, H, Ishida, M, Uchida, N, et al. (2019) Thiamine deficiency observed in a cancer patient's caregiver. Palliative and Supportive Care 13.Google Scholar
Sechi, G, Batzu, L, Agro, L, et al. (2016a) Cancer-related Wernicke-Korsakoff syndrome. Lancet Oncology 17(6), e221e222.Google Scholar
Sechi, G, Sechi, E, Fois, C, et al. (2016b) Advances in clinical determinants and neurological manifestations of B vitamin deficiency in adults. Nutrition Reviews 74(5), 281300.Google Scholar
Victor, M, Adams, RD, and Collins, GH (1971) The Wernicke-Korsakoff syndrome. A clinical and pathological study of 245 patients, 82 with post-mortem examinations. Contemporary Neurology Series 7, 1206.Google Scholar
Vir, SC and Love, AH (1977) Thiamine status of institutionalised and non-institutionalised aged. International Journal for Vitamin and Nutrition Research 47(4), 325335.Google Scholar
Wilkinson, TJ, Hanger, HC, Elmslie, J, et al. (1997) The response to treatment of subclinical thiamine deficiency in the elderly. American Journal of Clinical Nutrition 66(4), 925928.Google Scholar
Zisook, S and Shuchter, SR (1991) Depression through the first year after the death of a spouse. American Journal Psychiatry 148(10), 13461352.Google Scholar