Liaison Psychiatry in Cancer Care(Psycho-Oncology and QOL for Cancerous Patients)

Uchitomi Yosuke

doi:10.15064/jjpm.37.2_121

Liaison Psychiatry in Cancer Care, that is Psychooncology is concerned with the psychological, social, and behavioral aspects of cancer. This academic area addresses the two major dimensions : (1) psychosocial impacts of cancer on the quality of life of the patient : (2) the role that psychological and behavioral variables may have in cancer risk and survival. The latter area is also considered as psychoneuroimmunology, addressing the impact of mood states on the immune and endocrine systems that may contribute to cancer risk. Psychiatric epidemiological studies revealed that 20-30% of the hospitalized patients with cancer was moderately or severely depressed. However, only approximately 2% are referred for psychiatric consultation. Depression is frequently underestimated and undertreated because the diagnosis of depression is frequently clouded by neurovegetative symptoms (e.g. fatigue, insomnia, Ioss of appetite, psychomotor retardation and diminished ability to concentrate) that may be secondary to either cancer or depression. It is important to diagnse depression in cancer patients appropriately, since depression is responsive to brief supportive psychotherapy and psychotropic medications. The need for a large variety of psychosocial interventions is enhanced as increasing numbers of patients with cancer have longer survival. The primary goals of the psychosocial interventions for cancer patients are designed to have beneficial effects on quality of life. The second goal is to have beneficial effects on cancer risk and survival presumably by enhancing effective coping toward cancer and reducing affective distress as well as improving life style and compliance with medical regimens. Group psychosocial intervention for persons with high risk (e.g. genetic high risk group, heavy smokers) as well as early and advanced cancer have been carried out.

Liaison Psychiatry in Cancer Care(Psycho-Oncology and QOL for Cancerous Patients)

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