Double burden of cancer and bipolar disorder: Implications for mental health care

Table 1 Psychosocial and healthcare-related factors affecting cancer outcomes in patients with bipolar disorder

Domain	Key findings	Evidence	Impact on cancer outcomes	Clinical implications
Stigma	Severe mental illness patients less likely to receive screening	Observational studies	Delayed diagnosis, advanced stages	Need for proactive screening
Healthcare access	Reduced access to oncologic care	Population-based studies	Higher cancer mortality	Integrated care pathways
Diagnostic delay	Later-stage cancer diagnosis	Cohort studies	Poorer prognosis	Early referral strategies
Psychological distress	High rates of depression, anxiety	Clinical studies	Reduced treatment adherence	Routine psychiatric assessment
Psychosocial interventions	Cognitive behavioral therapy, supportive therapy effective	Randomized controlled trials in cancer populations	Improved quality of life and adherence	Adaptation for bipolar disorder needed
Care coordination	Multidisciplinary models beneficial	Integrated care studies	Improved continuity of care	Psychiatry-oncology collaboration

It provides an overview of major psychosocial and healthcare-related domains influencing cancer outcomes in patients with bipolar disorder and other severe mental illnesses. For each domain, key findings, type of supporting evidence, impact on cancer outcomes, and potential clinical implications are summarized. It emphasizes how stigma, reduced healthcare access, diagnostic delays, psychological distress, and inadequate care coordination can negatively affect cancer prognosis and treatment adherence, underscoring the need for proactive screening strategies and integrated psychiatry-oncology care models.