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Wood S, Bisson J. Br J Oral Maxillofac Surg 2004; 42: 149–154.

The effects of cancer surgery can be significant for many patients. Little is known about the best ways of managing psychological morbidity in cancer patients. This study covered 58 patients in a Welsh hospital who were referred to a mental health liaison nurse after radical surgical procedures including laryngectomy, glossectomy and block dissection of the neck.

Only one patient required psychiatric referral, although the nurse sought psychiatric advice about four others. Two were referred to the community mental health services for follow-up, and 10 patients were seen for more extensive exploration of issues of concern. Staff also needed reassurance about whether some patients were 'normal' especially when they thought patients were in denial. Many patients initially responded to the nurse that they 'were not mad'. The authors consider that routine assessment three months post-operatively might help to detect difficulties of adjustment, and pre-operative assessment might help predict difficulties.