a Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences , University of Ferrara , Ferrara , Italy.
b University Hospital Psychiatric Unit , Program of Psycho-Oncology and Psychiatry in Palliative Care, Integrated Department of Mental Health and Addictive Behavior , S. Anna University Hospital and Health Authority , Ferrara , Italy.
Int Rev Psychiatry. 2017 Oct;29(5):389-402. doi: 10.1080/09540261.2017.1288090. Epub 2017 Jul 28.
With cancer incidence increasing over time, attention to the burden of related psychiatric and psychosocial consequences of the disease and treatment is a major topic for both cancer patients and their caregivers. Among cancer patients, psychiatric (e.g. adjustment, anxiety, depressive disorders) and neuropsychiatric disorders (e.g. cognitive disorders secondary to treatment, delirium) have been shown to affect an average of 30-35% patients, with differences according to stage and type of cancer. Also other psychosocial syndromes (e.g. demoralization, health anxiety, irritable mood) not taken into account in usual nosological systems should be considered for their impact on the patient's quality-of-life. Also, it has been repeatedly reported that psychological distress reverberates substantially throughout the nuclear family, and that a family approach is necessary in cancer care, with the caregiver-patient dyad as a unit to be the focus and direction of assessment and intervention. In this review the most significant psychosocial disorders causing burden for cancer patients and their caregivers are examined, and the main methods of assessment for more proper referral and treatment are summarized.
随着癌症发病率的不断增加，关注癌症及其治疗相关的精神和心理社会后果的负担，已成为癌症患者及其照护者的主要话题。在癌症患者中，精神疾病（例如适应不良、焦虑、抑郁障碍）和神经精神疾病（例如治疗引起的认知障碍、谵妄）已被证明会影响平均 30-35%的患者，其差异与癌症分期和类型有关。此外，还应考虑到通常的疾病分类系统中未包括的其他心理社会综合征（例如沮丧、健康焦虑、易怒），因为它们会影响患者的生活质量。此外，有研究反复报道称，心理困扰会在核心家庭中产生实质性的影响，因此，在癌症护理中需要采用家庭模式，以照顾者-患者二人组作为评估和干预的重点和方向。在本次综述中，我们研究了对癌症患者及其照护者造成负担的最显著的精神心理障碍，并总结了用于更恰当转诊和治疗的主要评估方法。
