Dealing with Depression: Communicating with Cancer Patients and Grieving Relatives

Abstract

Cancer is an extremely stressful event for both the patients and their families, potentially leading to the development of depression, which has been shown to have a general prevalence of 15–25%. When left unaddressed, depression has a great negative influence on quality of life, coping strategies, and active participation in medical care of both patient and caregivers. The relational components of effective communication with depressed cancer patients and their family members include the clinician’s availability for listening, exploring emotions, identifying affective problems, and providing empathic responses, in order to promote reciprocal trust and consolidate the therapeutic alliance. Of first importance is correct assessment of the symptoms (e.g., cognitive-affective dimensions with/without exclusion of neurovegetative symptoms), for a correct diagnosis (e.g., differentiating major depression from minor depression, adjustment disorder, demoralization). Suicide assessment is extremely important in the context of cancer care. A second aspect is intervention, at the counseling level or more specific psychotherapeutic treatment. Several types of psychological therapy have been proved to be effective in treating depression of cancer patients and family members (e.g., cognitive-behavior therapy, supportive-expressive group psychotherapy, interpersonal psychotherapy, complicated grief therapy, family-focused grief therapy). A sensitive, collaborative, comprehensive approach to the diagnosis and treatment of depression is the cornerstone of communication. Clinical education and training of cancer care professionals and integration with psychooncologists are mandatory for providing adequate care to cancer patients and their families with depression.