Valente S M, Saunders J M, Cohen M Z
Cancer Pract. 1994 Jan-Feb;2(1):65-71.
The stress, diagnosis, and treatment of cancer cause substantial psychiatric morbidity that is treatable. Chemotherapy or other cancer treatments cause 40% to 60% of patients' emotional distress. Major depression develops in approximately 25% of patients with cancer, and less severe depressive symptoms develop in many patients, but fewer than half of the patients with symptoms are offered treatment. Alleviating major depression improves the quality of life for these patients with cancer. These patients, particularly during terminal illness, have an increased risk of suicide. Clinicians proficient in psychosocial assessment can detect subtle signs, monitor risk factors, reduce major depression with cognitive strategies, and prevent complications. Untreated major depression lowers life expectancy and treatment compliance and increases risk of suicide and cardiac disease. In this article, incidence of major depression among patients with cancer is discussed. Guidelines for diagnosis, correcting myths, and detecting major depression are suggested. Effective cognitive strategies for intervention are described; medical treatment is briefly reviewed. Detection and evaluation of suicide risk are discussed.
癌症的压力、诊断和治疗会导致大量可治疗的精神疾病。化疗或其他癌症治疗会使40%至60%的患者产生情绪困扰。约25%的癌症患者会出现重度抑郁症，许多患者会出现不太严重的抑郁症状，但出现症状的患者中接受治疗的不到一半。缓解重度抑郁症可提高这些癌症患者的生活质量。这些患者，尤其是在晚期疾病期间，自杀风险会增加。精通社会心理评估的临床医生能够发现细微迹象、监测风险因素、通过认知策略减轻重度抑郁症并预防并发症。未经治疗的重度抑郁症会降低预期寿命和治疗依从性，并增加自杀和心脏病风险。本文讨论了癌症患者中重度抑郁症的发病率。提出了诊断指南、纠正误解以及检测重度抑郁症的建议。描述了有效的认知干预策略；简要回顾了药物治疗。讨论了自杀风险的检测和评估。
