Goldberg R J
Postgrad Med. 1983 Jul;74(1):263-73. doi: 10.1080/00325481.1983.11697919.
Because cancer and its treatment have so many effects on the CNS, the diagnosis of psychiatric symptoms in cancer patients is problematic. Naturally there are psychologic and psychosocial issues that often sufficiently explain why a patient appears distressed. Dealing with psychologic adjustment is always an important part of the management of patients with severe medical, as opposed to psychiatric, illness, whether or not biologic components of the psychologic problem can be identified and addressed. The most frequent error physicians make in evaluating psychiatric symptoms is to assume that a psychologic explanation is sufficient. Expressions such as "Wouldn't you be depressed if you had cancer?" are often used to excuse failure to pursue further evaluation. Careful reviews of cases in which cancer patients were labeled as having psychologic problems have consistently shown a high incidence of misdiagnosis. Correct diagnosis and treatment of an underlying organic disorder can alleviate symptoms that impair the patient's innate coping resources, allowing him or her to grapple more effectively with adverse circumstances.
由于癌症及其治疗对中枢神经系统有诸多影响，癌症患者精神症状的诊断存在问题。自然地，存在一些心理和社会心理问题，这些问题常常足以解释患者为何显得痛苦。应对心理调适始终是重症内科疾病（而非精神疾病）患者管理的重要组成部分，无论心理问题的生物学成分能否被识别和解决。医生在评估精神症状时最常犯的错误是认为心理方面的解释就足够了。诸如“如果你患了癌症，你难道不会抑郁吗？”这样的表述常被用来为未能进行进一步评估找借口。对那些被诊断为有心理问题的癌症患者病例进行仔细回顾，一直显示出误诊率很高。正确诊断和治疗潜在的器质性疾病可以缓解那些损害患者内在应对能力的症状，使患者能够更有效地应对不利情况。
