Depressive Spectrum Disorders in Cancer: Diagnostic Issues and Intervention. A Critical Review

Abstract

Depressive spectrum disorders, including major depression, persistent depression, minor and sub-syndromal depression, and other forms of depressive conditions, such as demoralization, are among the most common psychiatric consequences of cancer patients, affecting up to 60% of patients. In spite of the negative effects and the burden for cancer patients and their families, these disorders often remain under-recognized and undertreated. The present review aims at summarizing the relevant data concerning the diagnostic challenges within the depressive spectrum disorders among cancer patients. Also, the most relevant data relative to integrated intervention, including psychopharmacological and psychosocial treatment, for depression in cancer patients are critically evaluated. It is mandatory that health care professionals working in oncology (e.g., oncologists, surgeons, radiation oncologists, primary care physicians, nurses, social workers, psychologists) receive training in the diagnosis and integrated management of the different types of disorder within the spectrum of clinical depression.

Advancing psychosocial care in cancer patients

“…the International Classification of Disease, tenth edition [ICD-10] of WHO or the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [DSM-5] of the American Psychiatric Association) 10 . The most common diagnoses include stress-related and adjustment disorders 11 , depressive spectrum disorders (including major depression and minor depression) 12 , 13 , anxiety disorders 14 , and sexual disorders (e.g. loss of libido and anorgasmia) 15 .…”

Psychoonkologisches Screening in der Palliativmedizin

“…Die Möglichkeit einer psychopharmakologischen Unterstützung sollte geprüft werden und muss in das onkologische Gesamtbehandlungskonzept eingebettet sein [27]. Die Arbeitsgemeinschaft Palliativmedizin (AG Palliativmedizin im CCC-Netzwerk) der von der Deutschen Krebshilfe (DKH) geförderten Comprehensive Cancer Center hat mehrere Standard Operating Procedures (SOP) veröffentlicht.…”

Psychoonkologisches Screening in der Palliativmedizin

“…Die Möglichkeit einer psychopharmakologischen Unterstützung sollte geprüft werden und muss in das onkologische Gesamtbehandlungskonzept eingebettet sein [27] Patienten, die auf einer Palliativstation versorgt werden, haben in der Regel einen niedrigschwelligen Zugang zur fachpsychologischen Versorgung. Auch bei stationären Palliativdiensten kann neben Arzt und Pflegepersonal ein Psychologe/Psychotherapeut/Psychoonkologe als drittes Teammitglied fungieren.…”