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Thiamine deficiency in the bereaved after cancer-related spousal loss

  • Hideki Onishi (a1), Nozomu Uchida (a2), Takao Takahashi (a3), Daisuke Furuya (a4), Yasuhiro Ebihara (a5), Izumi Sato (a6), Hiroshi Ito (a7) and Mayumi Ishida (a1)...

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.

Copyright

Corresponding author

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

References

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American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th ed, Washington DC: American Psychiatric Publishing.
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.
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.
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.
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.
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.
Holmes, TH and Rahe, RH (1967) The social readjustment rating scale. Journal of Psychosometric Research 11(2), 213218.
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.
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.
Isenberg-Grzeda, E, Kutner, HE, and Nicolson, SE (2012) Wernicke-Korsakoff-syndrome: Under-recognized and under-treated. Psychosomatics 53(6), 507516.
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.
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.
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.
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.
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.
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.
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.
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.
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.
MacLean, LD, Rhode, BM, and Shizgal, HM (1983) Nutrition following gastric operations for morbid obesity. Annals of Surgury 198(3), 347355.
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.
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.
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.
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.
Onishi, H, Ishida, M, Tanahashi, I, et al. (2018d). Subclinical thiamine deficiency in patients with abdominal cancer. Palliative and Supportive Care 16(4), 497499.
Onishi, H, Ishida, M, Tanahashi, I, et al. (2018e) Wernicke encephalopathy without delirium in patients with cancer. Palliative and Supportive Care 16(1), 118121.
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.
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.
Onishi, H, Ishida, M, Uchida, N, et al. (2019) Thiamine deficiency observed in a cancer patient's caregiver. Palliative and Supportive Care 13.
Sechi, G, Batzu, L, Agro, L, et al. (2016a) Cancer-related Wernicke-Korsakoff syndrome. Lancet Oncology 17(6), e221e222.
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.
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.
Vir, SC and Love, AH (1977) Thiamine status of institutionalised and non-institutionalised aged. International Journal for Vitamin and Nutrition Research 47(4), 325335.
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.
Zisook, S and Shuchter, SR (1991) Depression through the first year after the death of a spouse. American Journal Psychiatry 148(10), 13461352.

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