Assessment and treatment of depression in the cancer patient.
The prevalence, diagnosis, and treatment of depression in the cancer patient are reviewed. Although frequently encountered in the cancer patient population, depression often remains undiagnosed and untreated. This carries grave consequences in that depressed cancer patients experience a poorer quality of life, are less compliant with medical care, have longer hospital stays, and have higher mortality rates. Diagnostic assessment of depression in the cancer patient raises difficulties both upon phenomenological and etiological grounds. In particular, the presence of neurovegetative symptoms which may be secondary to either cancer or depression may cloud the diagnostic picture. Due to the serious consequences of unrecognized depression, a more sensitive inclusive approach to diagnosis is recommended in the clinical setting. Finally, the limited data regarding treatment of depression in patients with cancer is reviewed. This includes a discussion of both psychosocial and pharmacological interventions which are shown to alleviate depression, improve quality of life measures, improve immune function, and lengthen survival time.
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
D J
DJ
Newport
C B
CB
Nemeroff
D000324:Adrenocorticotropic Hormone / Q000134:cerebrospinal fluid; D001601:Bereavement; D003346:Corticotropin-Releasing Hormone / Q000134:cerebrospinal fluid / Q000378:metabolism; D003866:Depressive Disorder / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D005260:Female; D006304:Health Status; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000276:immunology / Q000378:metabolism; D007694:Killer Cells, Natural / Q000276:immunology; D008297:Male; D009369:Neoplasms / Q000523:psychology*; D010913:Pituitary-Adrenal System / Q000276:immunology / Q000378:metabolism; D011613:Psychotherapy / Q000379:methods; D011788:Quality of Life; D013315:Stress, Psychological / Q000134:cerebrospinal fluid / Q000523:psychology
D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone