Psychiatric Aspects of Psychosocial Distress in Cancer Patients

Abstract

This article reviews the identification and management of the two most common psychiatric disorders in cancer patients - delirium and depression. Physical consequences of cancer and its treatment can account for disorders of mood, thought, or behavior that appear on the surface to be indistinguishable from psychological, social, behavioral, or existentially mediated distress. Recognizing a medical basis for psychosocial distress is important because the impairment often has a specific, treatable cause and because the failure to treat may lead to premature loss of function and unnecessary alienation of the patient. In addition to reviewing common physiologic disorders in patients that present as psychosocial distress, the article addresses questions about mental status that are important in detecting organic mental disorders and the differential evaluation of depressive symptoms. Issues involved in the use of psychotropic drugs are also summarized. The author places the psychiatrist in the context of a mul...