The assessment of depression in patients with advanced cancer presents a difficult clinical challenge. Reported prevalence rates of depression in cancer patients range from 3.7% to 58%. Studies using structured diagnostic interviews and clearly defined diagnostic criteria are presented. The current literature suggests that among hospitalized cancer patients with significant levels of physical impairment at least 25% suffer from clinically important depression. Risk of suicide and recent literature regarding early wish to die are also discussed.
Get full access to this article
View all access options for this article.
References
1.
DerogatisLR, AbeloffMD, McBethCD. Cancer patients and their physicians in the perception of psychological symptoms. Psychosomatics1976; 17: 197–201.
2.
ComaroffJ, MacGuireP.Ambiguity and the search for meaning, childhood leukemia in the modern clinical context. Soc Sci Med1981; 1513: 115–123.
3.
MacguireP.The recognition and treatment of affective disorders in cancer patients. Int Rev Appl Psychol1984; 33: 479–491.
4.
DerogatisLR, FeldsteinM, MorrowG, SchmaleA, SchmittM, GatesC, MurawskiB, HollandJ, PenmanD, MelisaratosN, EnelowAJ, AdlerLM. A survey of psychotropic drug prescriptions in an oncology population. Cancer1979; 44: 1919–1929.
5.
MassieMJ. Depression. In: HollandJC, RowlandJH (eds). Handbook of Psychooncology: Psychological Care of the Patient with Cancer. New York: Oxford University Press, 1989; pp. 283–290.
6.
CraigKD. Emotional aspects of pain. In: WallPD, MelzackR (eds). Textbook of Pain. 2nd Ed. London: Churchill Livingstone, 1989; pp. 220–230.
7.
SchleiferSJ, KellerSE. Depressive disorders and immunity. In: PlotnikoffN, MurgoA, FaithR, WybranJ (eds). Stress and Immunity. Boca Raton, Florida: CRC Press, 1991; pp. 157–165.
8.
BreitbartW.Suicide. In: HollandJC, RowlandJH (eds). Handbook of Psychooncology: Psychological Care of the Patient with Cancer. New York: Oxford University Press, 1989; 291–299.
9.
ChochinovH.Desire for early death in 130 patients with cancer. (abstract). Proc Am Psychiat Soc Assoc, San Francisco, 1992.
10.
Diagnostic and Statistical Manual of Mental Disorders, Third Edition Revised. Washington DC: The American Psychiatric Association, 1987.
11.
RodinG, CravenJ, LittlefieldC.Depression in the Medically Ill. New York: Brunner/Mazel Inc., 1991; chapters 1,2.
12.
EndicottJ.Measurement of depression in patients with cancer. Cancer1984; 53: 2243–2249.
13.
RappSR, VranaS.Substituting nonsomatic for somatic symptoms in the diagnosis of depression in elderly male medical patients. Am J Psychiat1989; 146: 1197–1200.
14.
GoldenRN, McCartneyCF, . The detection of depression by patient self-report in women with gynecological cancer. Int J Psychiat Med1991; 21: 17–27.
15.
ChochinovHM, WilsonKG, EnnsM, LanderS.The prevalence of depression in the terminally ill: Effects of diagnostic criteria and symptom threshold judgements. Am J Psychiat1994: 151: 537–540.
16.
BukbergJB, PenmanD, HollandJC. Depression in hospitalized cancer patients. Psychosomatic Med1984; 46: 199–212.
17.
RosenDH, GregoryRJ, PollockD, SchiffmannA.Depression in patients referred for psychiatric consultation; a need for a new diagnosis. Gen Hosp Psychiat1987; 9: 391–397.
18.
FogelBS. Major depression versus organic mood disorder a questionable distinction. J Clin Psychiat1990; 51: 53–56.
19.
WilliamsJW, MutgiA, NoyesR, PerryP, KatholR.Comparisons of urinary-free Cortisol in depressed and non-depressed patients with’ malignancy. Biol Psychiat1990; 28: 522–525.
20.
SpitzerRL, EndicottJ, RobinsE.Research diagnostic criteria, rationale and reliability. Arch Gen Psychiat1978; 35: 773–782.
21.
RobinsLN, HeizerJE, CroughanJ, RatdiffKF. National Institute of Mental Health diagnostic interview schedule: its history, characteristics, and validity. Arch Gen Psychiat1981; 38: 381–389.
22.
ZigmondAS, SnaithRP. The hospital anxiety and depression scale. Acta Psychiatric Scandinavia1983; 67: 361–370.
23.
RazaviD, DelvauxN, BredartA, PaesmansM, DebusscherL, BronD, StryckmansP.Screening for psychiatric disorders in a lymphoma outpatient population. Eur J Cancer1992; 28A: 1869–1872.
24.
RazaviD, DelvauxN, FarvacquesC, RobayeE.Screening for adjustment disorders and major depressive disorders in cancer in patients. Br J Psychiat1990; 156: 79–83.
25.
BukbergJB, HollandJC. A prevalence study of depression in a cancer hospital population. Proc Am Assoc Cancer Res1980; 21: 382.
26.
PlumbMM, HollandJ.Comparative studies of psychological function in patients with advanced cancer: II. Interviewer-rated current and past psychological symptoms. Psychosomatic Med1981; 43: 243–254.
27.
DerogatisLR, MorrowGR, . The prevalence of psychiatric disorders among cancer patients. JAMA1983; 249: 751–757.
28.
MortonRP, DaviesADM, . Quality of life in treated head and neck cancer patients: a preliminary report. Clin Otolaryngol1984; 9: 181–185.
29.
DeanC.Psychiatric morbidity following mastectomy: preoperative predictors and types of illness. J Psychosomatic Res1987; 31: 385–392.
30.
EvansDL, McCartneyCF, . Depression in women treated for gynecological cancer: clinical and neuroendocrine assessment. Am J Psychiat1986; 143: 447–452.
31.
WeddingtonWW, SegravesKB, SimonMA. Current and lifetime incidence of psychiatric disorders among a group of extremity sarcoma survivors. J Psychosomatic Res1986; 30: 121–125.
32.
KatholRG, MutgiA, WilliamsJ, ClamonG, NoyesR.Diagnosis of major depression in cancer patients according to four sets of criteria. Am J Psychiat1990; 147 (8):1021–1024.
33.
HintonJ.Psychiatric consultation in fatal illness. Proc Roy Soc Med1972; 65: 29–32.
34.
LevineP, SilverfarbPM, LipowskiZJ. Mental disorders in cancer patients. Cancer1978; 42: 1385–1391.
35.
MassieMJ, GorzynskiJG, MastrovitaR, TheisD, HollandJ.The diagnosis of depression in hospitalized patients with cancer. Proc Am Soc Clin Oncol1979; 20: 432 (abstract C-587).
36.
MassieMJ, HollandJC. The cancer patient with pain: psychiatric complications and their management. Med Clin North Am1987; 71: 243–48.
37.
FarberowNL, SchneidmanES, LeonardCV. Suicide among general medical and surgical hospital patients with malignant neoplasms. Washington DC: US Veterans Ad-ministration. Med Bull1963; 9.
38.
BrownJH, HenteleffP, BarakatS, RoweCJ. Is it normal for terminally ill patients to desire death? Am J Psychiat1986; 143 (2):208–211.