Identifying and Treating Depression in Women With Cancer: A Primary Care Approach.
In general, depressive disorders in the US are more common in women than in men. In women with cancer, approximately 20% to 25% experience clinically significant depression and/or anxiety at some point during the course of medical treatment. This report profiles the differential diagnosis of depressive disorders as well as special medical variables, treatment options, and follow-up considerations for women with cancer. A range of psychotherapeutic and somatic treatments are available, with selective serotonin reuptake inhibitor antidepressants being the mainstay of drug therapy. Despite an array of available treatments, depression in patients with cancer remains underdiagnosed and undertreated; it is imperative that these patients be treated for both of their diseases. Depression left untreated in women with cancer may not only cause significant emotional suffering but also slower medical recovery, less adaptive health behaviors, and a negative effect on medical outcome and, ultimately, on survival. Patients who do not respond to conventional treatment approaches should be referred to a consulting psychiatrist for confirmation of diagnosis and consideration of other treatment options.
Strouse
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Cedars-Sinai Comprehensive Cancer Center, Los Angeles, Calif. & Department of Psychiatry, UCLA School of Medicine, Los Angeles, Calif.